Stroke is a leading cause of severe disability and third cause of death. Factors that affect cerebral circulation and perfusion in normal and diseased cases are of great importance. Despite recent studies on risk factors in stroke patients, it is still unclear whether certain risk factors differently affect different levels of cerebral arteries in stroke patients.This study aimed at identifying if there are certain risk factors leading to large artery disease (LAD) versus small artery disease (SAD) in ischemic stroke patients. Forty patients were included in the study 34 males and 6 females .History taking, clinical examination, neuroimaging and laboratory investigations were preformed to all patients. Patients with hemorrhage identified on brain imaging were excluded from the study. Results: lack of exercise was a risk factor to SAD (P<0.001).Elevated serum triglycerides was more of risk factor to SAD specifically the basal ganglia (P=0.02).Elevated hematocrite level was more associated with SAD(P0.04).Migraine with aura was risk factor commonly with LAD (P=0.04).Urinary tract infection was associated more with LAD (P=0.04).Cardiac diseases were commoner with large artery occlusion(P=0.005).Conclusion , lack of exercise is more common to cause SAD or in other words regular exercise is protective factor to SAD. Elevated hematocrite level and elevated triglycerides level are risky more to SAD.While cardiac diseases, migraine with aura and urinary tract infection are more risk to LAD.