Motor evoked potentials were recorded in 25 patients with ischaemic stroke within 72 hours of onset by transcranial magnetic stimulation. Motor power was graded according to MRC grading and the disability by Ranking scale. The patients could be grouped into those with normal MEPs (Group I) - 5 (20 per cent), those with prolonged CMCT and/or abnormal MEP/CMAP ratios or prolonged interside difference in CMCT on the hemiparetic side (Group II) - 12 (48 per cent) and those with no elicitable cortical MEPs on the hemiparetic side (Group III) - 8 (32 per cent). Patients with greater weakness and disability tended to have more abnormal or absent MEPs. No definite correlation could be seen with the site of infarct and MEP abnormalities. Patients with no elicitable cortical MEPs (Group III) showed no significant improvement in motor deficit at six months follow up. Where as patients in whom normal or abnormal cortical MEPs could be elicited (Group I & II) showed significant improvement. Evaluation of MEPs by transcranial magnetic stimulation early in acute ischaemic stroke can be used to predict stroke outcome.