Introduction: Ischemic stroke is the second leading cause of death and disability worldwide. Therefore, it is necessary that more neuroprotective treatments could be found. Ghrelin is a 28 amino acid peptide that is principally synthesized in the stomach mucosa but is also expressed in a variety of other tissues. Beside the well-known role in feeding and metabolism, there are some findings, that ghrelin could be neuroprotective in patients after stroke. Methods: Patients with a first acute ischemic stroke with functionally relevant hemi symptomatic symptoms were included until 24 hours after the event. The patient sample consisted of 14 patients with stroke (mean age = 73.6 years, range = 59 – 84 years, 6 female, 7 male, Table 1). All patients underwent the nine-hole peg test (NHPT) and a blood draw (ghrelin) on day one and three after stroke. In addition, the de Morton Mobility Index (DEMMI) was performed. Results: The comparison of the outcome of the patients with lower and higher ghrelin blood concentrations adjusted for age and gender revealed a trend of the patients with higher levels of ghrelin and a better outcome (DEMMI). Discussion: Ghrelin may be neuroprotective in patients with an acute stroke. However, further studies are needed to prove it.