Background-We aimed to determine the prevalence of hyponatremia on admission in ischemic stroke patients and to compare morbidity as well as mortality in ischemic stroke patients presenting with and without hyponatremia. Methodology-This study was conducted as a prospective cohort study on all patients with ischemic stroke admitted in People’s Hospital Bhopal those fulfilling inclusion criteria. during the study period on admission serum sodium was assessed and severity of ischemic stroke was determined using Modified Rankin Scale. Follow-up of all patients was done at discharge or death and after 1 month of discharge. Results-We reported hyponatremia in 37.3% cases with ischemic stroke, with mild, moderate and severe hyponatremia 31.4%, 2.9% and 2.9% cases respectively. Mortality was found in significantly higher proportions of cases with hyponatremia (p<0.05). Though we found no significant association of hyponatremia with mRS score at admission as well as at the time of discharge or death (p>0.05), hyponatremia was significantly associated with higher mortality rate after 1 month of discharge (p<0.05). Conclusions-Severe hyponatremia at the time of admission in hospital carries higher mortality in patients with acute ischemic stroke. Our study highlights the multifaceted impact of hyponatremia on clinical outcomes, treatment strategies, and short-term functional recovery in patients with ischemic stroke. The evaluation of hyponatremia levels can help us in understanding the severity at which a patient can develop adverse outcomes in stroke, thereby helping us to review and revise their management in time to decrease the mortality rate.