Background: Patients with transient ischemic attack (TIA) are generally clinically unstable, with fear of developing a handicapping stroke. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of costly secondary prevention strategies. Objective: Incorporation of a clinical scoring system, neurovascular imaging, and MR-DWI to help predicting risk of developing an ischemic stroke following a TIA. Subjects and Methods: A prospective observational study conducted on 25 patients with TIAs, 64% were females and 26% were males, with a mean age of 57.12 ±10.36. Patients were assessed clinically and an ABCD2 score was proposed. Patients have undergone Diffusion weighted imaging (DWI), within 24 hours from the event, and intra- and extra cranial duplex. Patients were followed up at intervals of 1 week, 3 months, 6 months and 1 year. Results: Six patients (24%) developed stroke on their follow up, most of them had their strokes within the first 3 months (66.7%), and had an initial ABCD2 score of ≥4. The development of stroke was associated with the presence of significant extra and/or intracranial vessel disease assessed by duplex (P=0.006) and the presence of acute lesions on their DWI (P=0.035).