Background: Vital parameters can draw attention to impeding clinical deterioration of patient with stroke. So; therapeutic positioning is important to promote patients‘ functional recovery. Aim: to investigate the effect of different therapeutic positions on selected vital parameters among patients with stroke. Design: A randomized control clinical trial design was utilized. Tools: I: Personal and Medical Background Information Form. IIObservational checklist tool records the selected vital parameters. III- Numerical Pain Rating scale. Setting: at the stroke unit in one of the Cairo University hospitals-Egypt. Sample: 104 adult patients who were diagnosed as stroke; their Glasgow Coma Scale were 9 to15. Results: There was a statistically significant difference before and after performing different therapeutic positioning in relation to selected vital signs; for example, in relation to heart rate scores on the second day of semi fowler's position (T test =1.930, p- value=0.056) and respiratory rate scores on the second day of semi fowler's position (T test =2.248, p- value=0.027). In addition, there was a significant difference between the study and control groups regarding oxygen saturation scores of all positions; for example, semi fowler's position (T test =2.35 , p- value=0.020) at the third day of positioning. Furthermore, the study and control groups respectively had no pain in the following positions: for example, semi fowler's position (88.5%), (84.6%). Conclusion: Vital parameters were improved after therapeutic Positioning.