Mostafa M MagdyStroke is the most common cause of long-term disability in adults throughout the world. Diffusion tensor imaging (DTI) is an emerging neuroimaging technique that allows measuring the integrity of corticospinal tracts (CSTs). Aim of the work: To compare the clinical scores and diffusion tensor parameters among the patients and controls; to detect the correlation between diffusion tensor findings and clinical scores at baseline and after 6 months follow up in patients presenting with acute ischemic stroke. Patients and methods: Thirty four patients with acute ischemic stroke subjected to clinical assessment using National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Medical Research Council (MRC) score, Morticity Index (MI) score and DTI to detect the degree of reduction of fractional anisotropy (FA), and pattern of CSTs at baseline and after 6 months follow up. Seventeen age, sex matched controls underwent DTI assessment.