Background: Ischemic stroke is a leading cause of morbidity and mortality worldwide, however, interventions to decrease the said morbidity and mortality are unequally availed by different populations. Therefore, an investigation into the clinical course of this disease in the population of Andaman & Nicobar Islands, which lie far from the Indian mainland, was well warranted. Aim: To examine the course of treatment and outcome of patients admitted with Ischemic Stroke to the Department of Medicine, GB Pant Hospital, Port Blair, Andaman & Nicobar Islands. Methods: The study is prospective observational in design, and follows patients admitted in the months of July to September 2022 during their period of admission. Results: Rate of IV thrombolysis was found to be significantly lower than the rate observed in mainland India (p=0.00005). This was primarily because very few patients, only4.44% of the patients presented to the hospital within 4.5 hours of onset of symptoms. Secondly, patient age > 65 years was associated with greater mortality (p=0.01714), and a relative risk of mortality of 4.42 was found in patients aged >65 years, when compared to patients ≤ 65 years of age. Conclusion: Increasing awareness about stroke and stroke thrombolysis is likely to be the most effective tool for improving outcome of patients with Ischemic Stroke in Andaman & Nicobar Islands, as very few (4.44%) patients, despite of living in close vicinity of the hospital, presented to the hospital within 4.5 hours.