Background: Many articles describing the comorbidities on the gastrointestinal, neurological, and respiratory manifestations of the COVID-19 infection. The cardiovascular system is often affected and caused acute myocardial infarction, venous thromboembolic events, and monitoring with high sensitivity cardiac troponin. Ischemic stroke remains the most common subset of neurological manifestations in COVID- 19 infection. Aim of research: This comparative cross-sectional retrospective study was carried out to assess and compare the association between COVID -19 infection and the risk of acute ischemic stroke among both Saudi and Egyptian infected patient. Subjects and Methods: Data was collected through a well-structured questionnaire, distributed among patients who infected with COVID-19 in Saudi Arabia and Egypt. The questionnaire includes patients’ Socio-demographic and history of chronic diseases, laboratory investigations, time of getting stroke after COVID-19 infection and symptoms of COVID infection and stroke, as well as stroke outcomes. Then, data was statistically been analyzed using (SPSS, version 25) statistical program. Results: 635 participants (288 Egyptians and 347 Saudis) were included in this study who were infected with COVID-19 and completed the data of the questionnaire. Most of participants were young (< 46 years old), and females. The total percent of participants who had stroke due to infection with COVID-19 and recovered without side effect was 1% & 1.2%, while 1.7% & 0.9% recovered but having some side effects among Egyptians and Saudis respectively. All these patients with stroke had medical history of cardiovascular diseases, hypertension, diabetes, dyslipidemia with elevated levels of D-dimer, C-reactive protein, white blood cell, neutrophils and low level of lymphocytes. Conclusion: Our research supports the fact that COVID- 19 infection is associated with a clinical outcome of ischemic stroke that tend to the highest rate of mortality. Also, more research is needed to examine the neurological implications of COVID-19 disease.