Stroke is a leading cause of death and disability worldwide. The association between serum uric acid and acute ischemic stroke (AIS) remains controversial. We aimed to evaluate the association between hyperuricemia and AIS, including stroke type, subtype, severity, and outcome.

This case‐control study was conducted at a tertiary care hospital in Uttarakhand, India. Ninety‐five patients with AIS and 95 age‐ and sex‐matched controls without ischemic stroke were randomly selected. Associations between hyperuricemia and AIS‐related parameters were analyzed.

The majority (67.4%) of patients were male, and nearly half (49.5%) were over 60 years of age. The most common stroke type was thrombotic (83.2%), and the predominant subtype was large artery atherosclerosis (53.7%). Hyperuricemia was significantly associated with AIS (p = 0.011) and stroke severity (p = 0.033), but not with stroke type (p = 0.201), subtype (p = 0.298), or functional outcome (p = 0.670); analyses of these secondary outcomes were exploratory and sample size‐limited. On univariate analysis, alcohol use, smoking, and hypertension were significantly associated with AIS (p < 0.05 each). On multivariable analysis, only hypertension remained independently associated with AIS (p < 0.001).

Hyperuricemia was associated with AIS and greater stroke severity but was not independently associated with AIS after adjustment. Further prospective studies are warranted to clarify its clinical significance.