Background: Levels of the cardiac muscle regulatory protein troponin-T (cTnT) are frequently elevated in patients with acute stroke and elevated cTnT predicts poor outcome and mortality. The pathomechanism of troponin release may relate to co-morbid coronary artery disease and myocardial ischemia or, alternatively, to neurogenic cardiac damage due to autonomic activation after acute stroke.The aim of the work: Was to assess the level of troponin-T in the sera of acute stroke patients and its effect on stroke severity.Patients and methods: Fifty patients with acute cerebrovascular stroke (25 with intracerebral hemorrhage, 25 with acute ischemic stroke) diagnosed by brain CT scan. Serum cardiac troponin-T (cTnT) and creatine kinase-myocardial band (CK-MB) levels were measured by immunoassay in all patients at the time of admission and five days later. Twelve lead electrocardiograms (ECGs) were done at the time of admission and 12 hours later. The stroke severity was assessed by Scandinavian stroke scale(SSS).Results: Serum cardiac troponin-T was elevated in 17 patients, (8 patients with hemorrhage (32%), and 9 with infarction (36%)). Abnormal ECGs findings were observed in 27 cases, (13 patients with hemorrhage, and 14 with infarction). All patients with elevated serum troponin showed abnormal ECG (100%). ECG changes were more in patients with elevated cTnT than in patients with elevated CK-MB .There is a positive correlation between Elevated cTnT sreum levels and Scandinavian stroke scale and mortality. CK-MB was not elevated in most patients with elevated cTnT, the non parallel increase of CK-MB with cTnT may signify the non cardiac source of CKMB . Patients with a left parietal lobe stroke compared with those with stroke in other brain locations were at higher risk of myocardial injury. Conclusion: Measurement of the serum level of cardiac troponin-T provides a useful measure in assessment of the prognosis of the stroke in clinical practice. Serum cardiac troponin-T is a sensitive marker in detecting myocardial injury after cerebral stroke . Key Words: Cardiac troponin-T; creatine kinase-MB; stroke; myocardial injury.Abbreviations: Cardiac troponin-T (cTnT), creatine kinase-myocardial band (CK-MB), electrocardiogram (ECG), Scandinavian stroke scale (SSS).