INTRODUCTION: Stroke is the commonest neurological cause of morbidity & mortality all over the world, being the second most frequent cause of death after heart diseases and most frequent cause of permanent disability. There are a number of risk factors associated with stroke; hypertension, diabetes mellitus, tobacco use, anemia and hyperlipidemia being the most important ones. The socioeconomic burden to meet the costs of management of chronic debilitating diseases like stroke is enormous and therefore emphasis on preventive strategies of stroke is crucial as it alters the incidence, course & the prognosis of the disease. It is of the utmost significance to know the important risk factors associated with stroke in a particular community. This study was therefore conducted to find out the modifiable risk factors in the stroke patients of western Maharashtra. AIMS AND OBJECTIVES: This observational study was conducted in department of medicine from February 2013 to June 2014 to study the clinical profile and risk factors in patients of stroke. Fifty stroke patients admitted in the medical ICU were studied. RESULTS: Tobacco use (82%) was the commonest risk factor for stroke, closely followed by Hypertension (80%). Hyperhomocysteinemia (58%), Dyslipidemia (48%), and Obesity (46%) ranked 3rd, 4th and 5th respectively in the list. Contributions by metabolic syndrome, diabetes mellitus and alcohol was 36%, 30%, 30% and 12% respectively. Twenty six percent patients had left ventricular hypertrophy (LVH) and 12% had atrial fibrillation (AF). Severe carotid stenosis was present in 8% of patients, while moderate carotid stenosis in 10%. CONCLUSION: A positive, statistically significant relationship between age, sex, hypertension, diabetes mellitus, tobacco use, obesity, metabolic syndrome, hyperhomocysteinemia and stroke was observed.