Background: Atrial cardiopathy (AC) is still one of the most important mechanisms behind cryptogenic stroke. Indeed, atrial cardiopathy may be the underlying cause of embolic stroke even in absence of AF. Thus, detection of AC has a great value for therapeutic purposes and secondary prevention of further thrombo-embolic events. The aim of the study was to evaluate the left atrial function to detect atrial cardiopathy and early predicting AF. Methods: The study included 62 patients who proved to have ischemic stroke of unknown etiology (CS) presented to neuropsychiatry department or out-patient clinic of Minia university hospital after exclusion of high risk patients for cardio-embolism or recognized causes of stroke. Two-dimensional Echo-Doppler study of left atrium was done and at least 48 hours rhythm monitoring during hospitalization. Results: AF-recorded (32%) and non-AF recorded (68%). LAVI in AF-recorded group (Mean ± SD = 46.3 ± 4.1) with p-value = 0.0001, while LV diastolic function assessment in AF-recorded group (40% with normal diastolic function) (30% with grade I LVDD) (30% with grade II LVDD) with p-value = 0.158. Conclusion: Evaluation of atrial cardiopathy by 2D echocardiography is important and of great clinical value for prediction of AF in patients presented with cryptogenic stroke or TIA. LAVI is a sensitive parameter for detection of AF in comparison with LV diastolic dysfunction assessment by pulsed-Doppler and tissue Doppler imaging.