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Abstract : introduction : Stroke is the most common cause of preventable disability and one of the most common causes of mortality all over the world. Western studies have shown that etiology, risk factors and outcome of stroke in young adults are dierent from that of older stroke patients. Indian studies regarding the comparison of young and old stroke patients are limited.objectives: To compare the clinical characteristics, risk factors, etiology, drug utilization patterns, adverse drug reactions and func-tional outcomes in young and old stroke patients admitted in a comprehensive stroke care centre.methods: This observational study was conducted in 240 adult patients who were admitted in the Comprehensive stroke care de-partment of a tertiary care hospital for a period of 44 months (January 2012- September 2015). The study duration was three years. Data on type of stroke, risk factors, etiology, type of antithrombotic therapy, recurrence of stroke and adverse drug reactions in patients was collected from medical records and hospital information system using a standard proforma. Follow up on functional outcome, medication compliance and adverse drug reactions to antithrombotic therapy were done by either telephonic interview or direct conversation with the patient or family members. Mann Whitney test was used to compare continuous variables and Chi-Square test was used for categorical variables and p<0.05 was considered signicant. Results: In the present study, 80 young and 160 old patients were studied. Both the groups showed a male preponderance. The commonest type of stroke was ischemic stroke (78.7% young v/s 88.1% old) in both groups. The etiology was undetermined for young patients (40%) while cardiac embolism was the etiology in 32.5% of the old patients. Hypertension was the most common cardiovascular risk factor in both groups (48.7% young v/s 75% old). Aspirin was the most commonly prescribed antiplatelet drug (76.1% young v/s 90% old) in both groups. Both the groups had good compliance to medications and the dierence was not statistically signicant. Minor bleed was the most common adverse drug reaction (7.5% young v/s 11.2% old) seen. Unfavourable functional outcome was signicantly lower in young compared to the old (48% in young patients v/s 72.8%in old patients). Stroke recurrence was seen less in the young compared to old (8.8% v/s 15.1%) patients.conclusion: There are signicant dierences in the stroke etiology, risk factors, antithrombotic therapy and functional outcome between the young and old stroke patients.