Background and Aim: Microalbuminuria (MA) signifies abnormal vascular permeability and its presence may be considered as kidney's notice for markedly enhanced cerebrovascular risk. Urine albumin-to-creatinine ratio (UACR) is linked with the risk of stroke. This study aimed to determine the prevalence/frequency of MA or UACR in acute ischemic stroke patients. Methodology: This is a case-control study conducted with total of 140 patients from December 2023 to December 2024. 70 patients with no history of stroke and transient ischemic attack were enrolled in control group. Another 70 patients with symptoms suspicion stroke were enrolled in case group. The severity of stroke was assessed by National Institutes of Health Stroke Scale (NIHSS). Results: The mean age of study subjects in control and cases group was found to be 53.06 ± 14.97 and 54.57 ± 14.03 years.  Male predominance was observed in both control (58.60%) and cases (67.10%) groups. Hypertension is the major comorbid condition observed in both control and cases group followed by diabetes mellitus. Majority of the study subjects enrolled in the study i.e., 35.7% were suffering from small vessel followed by cardioembolic (34.3%), and large vessel (30%). The mean UACR of study subjects in control and cases group was found to be 17.21 ± 7.27 and 497.83 ± 427.29 respectively with statistically significant difference (p<0.0001) between control and cases. Majority of the study subjects enrolled in the study i.e., 30% were suffering from moderate to severe stroke followed by minor & moderate stroke (24.28%), and severe stroke (21.42%). Conclusion: Microalbuminuria may be an important prognostic marker in acute ischemic stroke. Furthermore, it was inferred that that urine albumin excretion might be much more dependent on the severity of the stroke process than age. Higher the NIHSS score more the urine albumin excretion and vice versa