OBJECTIVE: The components of metabolic syndrome ‘X,' which include elevated insulin levels, poor glucose tolerance, high triglyceride levels, central obesity (sometimes known as an "apple body"), and high blood pressure, are significant in the Indian setting. Those who suffer from metabolic syndrome are at an elevated risk of developing coronary heart disease and ischemic stroke by a factor of two to three. This research aimed to compare the components associated with metabolic syndrome and neurological examination in patients with metabolic syndrome with non-metabolic syndrome patients in cases with the acute ischaemic syndrome. METHODS: Fifty patients were observed between October 2020 and August 2022 at the D.Y. Patil Medical College Hospital and Research Institute in Kolhapur as part of this observational research. The National Cholesterol Education Program Adult Treatment Panel III's definition of metabolic syndrome was used here. RESULTS: In the present study, we found that out of 50 patients with ischemic stroke, 31 (62%) were found to have metabolic syndrome. In both groups, most stroke patients were from the age group 61 to 80 years (45.16% and 57.89%), respectively. Stroke patients showed the most common symptoms being weakness (96.77%) followed by deviation of the angle of the mouth (54.84%). Most stroke patients with Metabolic Syndrome and non-Metabolic Syndrome had upper limb and lower limb tone of grade 3 and power grade 0 power. Mean Waist circumference was significantly high in Metabolic Syndrome patients compared to nonMetabolic Syndrome Patients. Mean fasting Blood Sugar level, and Fasting Triglyceride was significantly high; in contrast, mean HDL values were significantly low in patients with Metabolic Syndrome compared to non-Metabolic Syndrome (p-value <0.05). CONCLUSION: 62% of persons with acute ischemic stroke also have Metabolic Syndrome, according to our data. Our results verified the necessity of establishing preventative interventions to control MetS and each component condition to lower the risk of future ischemic stroke. This led to a better understanding of people at an increased risk for this kind of stroke.