Background: Acute ischemic stroke is one of the most common macrovascular complications and considered one of the leading causes of mortality and morbidity. & Gamma-glutamyl transferase (GGT) is a second generation enzymatic liver function test available for several decades. High levels of Gamma Glutamyl Transferase (GGT) have recently been recognized to be associated with increased risk of atherosclerotic cardiovascular diseases. Patients and methods: The study was conducted on fifty patients with acute ischemic stroke in the 1st 24 hours of presentation at the age group (43-72) in addition to twenty normal control group of the Kasr EL-Ainy hospitals, Cairo University, complete history and examination done and blood sample was taken for chemistry also CT brain and carotid duplex are done. Results: there was a positive relation between mean serum GGT level and acute ischemic stroke especially within the upper quartile of serum GGT also there were correlation between GGT and metabolic syndrome &carotid stenosis &National institute of Health stroke scale. Conclusions: It was concluded that there is statistically significant correlation between the mean serum GGT and the acute ischemic stroke and its severity.