The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke. Two-hundred and forty-five consecutive stroke patients were included. Each underwent detailed neurological assessment and cranial computed tomography without intravenous contrast injection. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model. Computed tomography showed that 76% of the patients had infarcts. 11% had haemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarcts. The temporal, parietal and frontal regions and the basal ganglia were most often affected. We concluded that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase.