Background: In adults, stroke is the leading cause of epilepsy. Seizures that occur after a stroke are of two distinct types; those that manifest early after the stroke and those that manifest much later the clinical course and occurrence of late seizures can be considerably influenced by early seizures. The objective of the current study is to investigate the predictors of early seizure after an acute ischemic stroke and the impact of these seizures on outcome of the patients. Patients and methods: A case-control study was conducted in the intensive care unit (ICU) of Neurology Department, Zagazig University Hospitals and New Mansoura General Hospital. A total of 60 subjects were included: 30 patients with acute ischemic stroke with early seizures (case group) and 30 patients with acute ischemic stroke without seizures (control group). Evaluation of the severity of neurologic deficits was done by using National Institutes of Health Stroke Scale (NIHSS). All patients' short-term outcomes were evaluated using a modified Rankin Scale. Results: There was a statistically significant higher mean NIHSS score and mean Modified Rankin scale among the case group than the control group. The etiologies of ischemic stroke were 46.7% of the cases had cardio embolic stroke, 40% atherosclerotic and 13.3% lacunar. The distribution of the ischemic stroke according to infarction size was 56.7% large, 30% medium and 13.3% small. Among the case group 53.3% had cortical involvement and 30% had hemorrhagic transformation. Conclusion: Predictors of early post-acute ischemic stroke seizures were large infarction size, cortical site, and patients with hemorrhagic transformation. Also, early post-acute ischemic stroke seizures were associated with more severe disease and poor outcome.