Objective: The aim of this study was to compare the electrocardiographic (ECG) abnormalities in patients with acute ischemic and hemorrhagic stroke who had no history of heart disease. Methods: During 12 months, 222 consecutive stroke patients were enrolled in this study. Of them 162 had ischemic stroke and 60 had hemorrhagic stroke. Frequency of arrhythmias and ECG changes were compared between two stroke groups. Electrocardiographic abnormalities included ischemia-like changes (ST-segment depression or elevation, abnormal T and U waves), QTc prolongation and arrhythmias. Results: Ischemic stroke patients were elder than hemorrhagic ones (64±14 vs 57±13 years, p=0.003). Other clinical characteristics were comparable in both groups. Ischemia-like ECG changes were found in 65% of ischemic stroke patients while they were observed in 57% of hemorrhagic stroke patients (p=0.33). Atrial fibrillation was more frequent in ischemic stroke than in hemorrhagic stroke (34% vs 13%, p=0.01) patients. Individually, other ECG abnormalities were not different in both groups. With relation of ECG abnormalities to location of the brain lesion, there was a trend in favor of involvement of the temporal, frontal and parietal lobes. Conclusion: Regardless stroke-related lesion, ECG abnormalities can be seen frequently in stroke patients without primary heart disease. They can lead to diagnostic and therapeutic difficulties for cardiologists and neurologists.