Ischemic heart disease and stroke are the leading cause of morbidity and mortality worldwide. Ischemic stroke and ischemic heart disease have similar pathophysiological mechanisms and risk factors. Ischemic heart disease patients are associated with increased morbidity and mortality, but the studies describing outcomes of ischemic heart disease in ischemic stroke patients are a lack. This is the first study to correlate ischemic heart disease in ischemic stroke with length of stay and functional outcome by using modified Rankin Scale (mRS). This study aims to compare the clinical outcome of ischemic stroke patients with ischemic heart disease and without ischemic heart disease.Methods: This retrospective cohort study of 200 patients were first incident acute ischemic stroke recorded in the Bethesda Hospital Yogyakarta Stroke Registry (2012-2017). These patients were divided into ischemic stroke patients with ischemic heart disease and ischemic stroke patients without ischemic heart disease. The primary outcomes of the study was in-hospital mortality, disability measured by modified Rankin Scale (mRS), and length of stay. The data were analyzed bivariate followed by the Chi-square test and Mann-Whitney.Results: Data of 200 patients with 100 stroke patients with ischemic heart disease consist of fifty-eight male (58.0%) and eighty-six (86.0%) were more than 50 years old. Compare to 100 stroke patients without ischemic heart disease consist of fifty-eight male (58.0%) and eighty-nine (89.0%) were more than 50 years old. The mortality of stroke patients with ischemic heart disease group is eighteen patients (18.0%), sixty patients (60%) have poor functional outcome (mRS >2) and have length of stay 7.50 (0-40) days. Bivariate analysis showed stroke patients with ischemic heart disease group is significantly associated with higher in-hospital mortality (RR:2.9, 95%CI:1.1-7.3, p<0.019), worse disability (RR:2.6, 95%CI:1.3 -5.1, p<0.005) and prolonged hospital stay (7.50 (0-40) vs 4 (0-14), p<0.001) than in stroke patients without ischemic heart disease group.Conclusion: Ischemic stroke patients with ischemic heart disease is statistically significantly associated with higher in-hospital mortality, worse disability, prolonged hospitalization than in ischemic stroke patients without ischemic heart disease.