Background: Cerebrovascular stroke (CVS) is the second most common cause of death after ischemic heart disease and the third most common cause of disability after ischemic heart disease and cancer. Objective: Investigating the time lags and the factors causing pre hospital and in hospital delays after acute ischemic stroke. Patients and Methods: This study included 70 patients recruited from the Neurology Department Al -Azhar University (Al Hussein Hospital) and El Sahel Teaching Hospital during the period from November 2018 to June 2019 with the diagnosis of acute ischemic stroke. Results: The pre hospital time ranged from 6 to168 hours with mean 32.657 ± 32.838 hours. The laboratory time ranged from 48 to 70 minutes with mean 56.943 ± 4.943 minutes and computed tomography time ranged from 15 to 40 minutes with mean 27.271± 5.868 minutes. The results revealed that pre hospital delay was due to lake of awareness about stroke symptoms and signs, late decision to seek medical care and lake of transportation by Emergency Medical System, and revealed that in hospital delay due to delayed laboratory investigations and computed tomography completion time. Conclusion: The time interval between the onset of symptoms and the decision to call for medical care was far from optimal in patients with acute stroke, and was the underlying cause of the prolonged pre hospital delay. The present study revealed that all patients arrived at our hospitals were too late to benefit maximally from the emerging stroke therapies.