Background: Stroke is one of the common causes of morbidity and mortality throughout the world. Numerous risk factors have been identified for stroke and modification of these risk factors has always been the crux of primary and secondary prevention. There has always been a concern regarding control of modifiable risk factors wherever possible and serum homocysteine especially merits attention in this regard as majority of Indians are vegetarian, a diet poor in vitamin B12, which is a cofactor in the metabolism of homocysteine. Methods: Patients with acute ischemic stroke admitted at Indraprastha Apollo Hospital, New Delhi during the study period (June 2015 to March 2017), who were suitable for the study as per our inclusion and exclusion criteria. Fasting levels of homocysteine and vitamin B12 in serum were collected within first 5 days of admission. Patients were subcategorized in two major subgroups according to TOAST criteria for the classification of stroke. Results: A total of 139 patients were included in the study. About half of patients were vegetarian (50.4%) followed by non–vegetarian (38.1%) and Occasional non–vegetarian (11.5%). Small vessel disease was seen in 56.1% patients and large vessel disease was in 43.9%. Homocysteine was insignificantly (p>0.05) higher in small vessel (24.75±18.37) than large vessel (24.64±20.74) group. Conclusion: In this trial Hyper–homocysteinemia was seen in majority of the patients (61.87%; 86 out of139 patients). Serum homocysteine was significantly higher among vegetarians than Nonvegetarians and Occasional non–vegetarians. Vitamin B12 was significantly lower among vegetarians compared to Nonvegetarians and Occasional non–vegetarians.