Background: Red cell distribution width (RDW) is a critical parameter that is reported to have a relation with the incidence and prognosis of cerebrovascular strokes. Altered RDW has been shown to predispose to the development of vascular thrombosis which is the underlying cause of cerebrovascular disease. We in the current study tried to evaluate the relationship between RDW values and stroke severity and prognosis. Methods: N=50 cases of acute ischemic stroke and age and sex-matched controls were included in the study. The patients were analyzed with a detailed history with the profile of stroke, GCS, NIHSS, mRS, including risk factors such as hypertension, Diabetes mellitus, IHD, and vascular risk factors. All the patients were subjected to 12 lead ECGs, 2D Echo, and CT scans. The sample was sent to the Department of Pathology for complete blood analysis including RDW. Results: the cases were divided into two groups those with RDW ≥14.5 and those with RDW ≤14.5. We found 62% of cases with RDW ≥14.5 and 28% cases with RDW ≤14.5. We found CRP levels, MCV, Modified Rankin Scale mRS, and Stroke size significantly increased in patients with RDW ≥14.5. Analysis of cases based on RDW in both groups the p-values was found to be 0.0122 considered significant. The diagnostic value of RDW levels at the cutoff value of 13.5 found the sensitivity was 76.5% and specificity was 75.8%. Conclusion: RDW is an important indicator of the prognosis of ischemic stroke. Although the exact mechanisms underlying it has not been fully elucidated, it may be used routinely in laboratories as it is inexpensive, and when combined with GCS, NIHSS, and mRS parameters it could provide information on stroke severity and increased risk of mortality.