Background: Stroke is frequently thought of as an old age disease, yet 10% of stroke victims are thought to be under the age of 45. Although the causes of this increase are unknown, there is evidence that the incidence of ischemic stroke in young adults is growing. A different strategy to inquiry and care is needed for stroke in the young compared to stroke in the old. Patients undergoing carotid revascularization operations benefit from the diagnostic and post-interventional evaluation of carotid artery disease provided by neurosonology. Objective: This study aimed at studying the risk factors and most common etiologies of stroke in young adults. Patients and Methods: We recruited patients with acute ischemic stroke or transient ischemic attack with age older than 18 and younger than 40 years old, who were admitted in the Stroke Unit –Neurology department, Kasr-Alainy Hospital within the first week of acute event. Results: Analysis was done for 70 ischemic stroke patients from urban and rural areas. In Males, cardio-embolic, drug-induced and undetermined causes were the most common etiologies for stroke representing together 63.3% (21 patients). While among females, about half of the cases (48.6%) were due to cardio-embolic etiology. Age was significantly lower in stroke of other determined etiology (p < 0.01) and significantly higher in stroke of undetermined etiology (p=0.01). Conclusion: Stroke in young adult patients still has more specific causes, which are less common in the older age group. So, diagnosis needs a more oriented approach to reach the proper stroke etiology for further secondary prevention in those patients.