A registry of hospitalized stroke patients in Denmark included 1,909 patients with stroke and atrial fibrillation (AF) without contraindications to anticoagulation (AC) treatment. AC instituted in 60.2% was significantly associated to age and stroke severity. In a Cox Proportional Hazard regression model the risk of death was doubled in patients who had no AC treatment (HR =1.91, 95% CI=1.44 to 2.52). The study indicates under-use of AC in elderly stroke patients with AF, leading to increased mortality.