The aim of this study was to identify early prognostic factors in children with ischemic arterial stroke. Presenting symptoms, patterns of infarction on magnetic resonance imaging and computed tomography scans, and etiologic findings were compared with clinical outcome in a consecutive series of 31 children with ischemic arterial stroke. Presentation with an altered level of consciousness, seizures, or both and a completed or cortical completed stroke of the middle cerebral artery were found to be significant risk factors for poor outcome. No significant correlation was found between prognosis of childhood stroke and etiology, age at presentation, or gender.