Introduction: Acute ischaemic infarction is the third etiology of death and first etiology of disability across the globe. Cerebrovascular accident is an emergency condition requiring immediate intervention. The blood brain barrier compromised in patients with acute ischaemic stroke, leakage of neuro-biochemical protein markers like NSE into the peripherial circulation allow pathogenesis and prognostication of patient‘s with CVA to be weighed up additionally. The current work structured to determine the marker of brain damage, NSE in serum of patient‘s with acute ischaemic infarction as a diagnostic and/or monitoring tool for early prognosis of ischaemic stroke. Objectives: Study of neuron-specific enolase as potential biomarker for assessing the severityand outcome in patients with acute ischaemic stroke. Materials and Methods: The material for the present study will be collected from patients who attend the Outpatient department and Inpatient department in BLDEU‘S Shri. B.M.Patil Medical College Hospital and Research Centre, Vijayapur over a period 2 years from November 2017 to June 2019. The sample size was 94 of which 47 were acute ischemic stroke patients who were studied as cases and 47 non ischaemic stroke were taken as controls and there serum NSE, GCS, NIHSS, mRS, infarct volume were estimated and the results obtained were statistically computed. Results: In present study, Mean NSE in cases-5.558.Mean NSE in controls-0.217. In the ROC Curve for NSE, area under ROC of NSE is100% and the optimal cut offivalue is 1.48,SENSITIVITYis100%.P-value for NSE & GCS is 0.2920.P-value for NSE & NIHSS is <0.001.P-value for NSE & mRS is <0.001.Coefficeint of correlation between NSE and infarct volume r=0.026 Conclusion: Serum NSE can be used for early diagnosis, prognosis ofiacute ischaemic stroke p atients in the settings were CT scan,MRI scan not available or patients in whom CT sca n or MRIiscan contraindicated or CT scan normal. Serum NSE test may be boon to prima ry health centres and useful to reduce morbidity and mortality associated with ischaemic stroke patients with early treatment initiation.