Background: Changes in the lipid profile have been reported as a risk factor for ischemic stroke in a few kinds of literature. The aim of the present study was to evaluate the lipid profile levels in ischemic stroke patients and its association with acute ischemic stroke within the first 24 hour. Materials and methods: It was a cross-sectional analytical study, conducted among above 35 years old aged acute ischemic stroke patients. A total of 48 cases and 48 controls were taken. Computed tomography (CT) scan, clinical examination, and fasting lipid profile of the admitted patients were done. A standard questionnaire was used for data collection. Results: History of hypertension, and diabetes mellitus was significantly higher among stroke patients (64.6 and 52.1%, respectively) than in the control group. The present study has found that the mean of total cholesterol (TC) was significantly higher (221.50 ± 42.89 mg/dL) in the stroke group than the control group (163.25 ± 18.01 mg/dL). The triglyceride level, very low-density lipoprotein (VLDL), and low-density lipoprotein (LDL) cholesterol level among the stroke patients’ group were significantly higher (193.95 ± 39.23, 38.77 ± 7.83, 144.32 ± 42.15 mg/dL, respectively) compared to the control group (139.12 ± 18.28, 27.82 ± 3.65, 91.94 ± 17.62 mg/dL, respectively). High-density lipoprotein (HDL) cholesterol level was significantly lower (36.81 ± 3.35 mg/dL) than the control group (44.10 ± 3.15 mg/dL). Multivariate logistic regression found that a higher triglyceride level had 0.94 odds of having ischemic stroke (95% CI: 0.88–0.99). Conclusion: Increased level of TC was found as a risk factor in ischemic stroke whereas high triglycerides (TG) levels had a protective role against ischemic stroke events. Reduction of cholesterol levels can reduce the incidence of ischemic stroke.