Background: Stroke is a major public health problem that ranks in the top four causes of death in most countries. Dyslipidemia including High Lipoprotein (a) [LP (a)] in blood are the risk factor for coronary heart disease (CHD), cerebrovascular disease (CVD), atherosclerosis, thrombosis, and stroke. Therefore this study was designed to find out the prevalence and patterns of dyslipidemia in cases of acute ischemic stroke and its relation to age and sex and to study the effect of dyslipidemic patterns and other modifiable risk factors on mortality of ischemic stroke patients. Subjects and methods: 105 subjects with acute ischemic stroke were diagnose clinically and radiologically by brain CT scan or MRI, and were subjected to full history ,clinical examination , routine investigations and calculation of Glasgow coma scale (GCS) and APACHE II score, in addition to 12-14 hour fasting lipid profile and LP (a). Results: Dyslipidemia and LP (a) was highly prevalent among cases of acute ischemic stroke, with significantly higher prevalence in males than females. High LDL-C is the most prevalent pattern. TC was significantly more frequent in males than females. High TC/HDL & TG/HDL ratios showed a wide prevalence, even more frequent than each individual lipid pattern of dyslipidemia. Dyslipidemia, previous stroke, smoking, HTN, and DM increased relative risk of mortality of ischemic stroke patients by 2.8, 2.6, 1.5, 1.3, and 1.2 fold respectively. While, high TC, high LDL, high TG, low HDL, high LP (a), high TC/HDL, and high TG/HDL increased the relative risk of the mortality of ischemic stroke patients by: 3.9, 3.43, 1.96, 1.4, 1.46, 2.78, and 1.3 fold respectively. APACHE II score was positively correlated with dyslipidemia and high TC. Conclusion: Dyslipidemia is one of the major risk factors, which is widely frequent among cases of ischemic stroke. High LDL and LP (a) is more frequent than other patterns of dyslipidemia in ischemic stroke subjects. This emphasizes their role as risk factors of ischemic stroke. APACHE II score was the most significant predictor of mortality of ischemic stroke cases, followed by TC/HDL ratio and GCS.