Anti phospholipid antibody syndrome is autoantibody-mediated acquired thrombophilia characterized by recurrent arterial or venous thrombosis. It may occur alone (Primary) or associated with other autoimmune disorders (secondary). We report a case of ischemic stroke in a young individual caused by anti phospholipid antibody syndrome INTRODUCTION: Anti phospholipid antibody syndrome is a rare cause of stroke in young 1. APLAS is characterized by systemic venous and arterial thrombosis, the latter occurring most often in the cerebral circulation, foetal loss, seizures, thrombocytopenia and pulmonary hypertension 2 Anticardiolipin antibodies (aCL) and lupus anticoagulant (LA) are two important antibodies found in this disease which cause both venous and arterial thrombosis 3. We report a case of young stroke having Anticardiolipin antibodies positive on twice occasion which highlight the importance of screening these antibodies in cases of young stroke. CASE PRESENTATION: A 32 year old male, agricultural labourer presented to emergency room with an H/O difficulty in getting up from bed in the morning and weakness of right upper limb and right lower limb. Weakness was sudden in onset, non-progressive maximal at the onset, involving both proximal and distal muscles (predominantly proximal). No history suggestive of cranial nerve/posterior column/sensory system/cerebellar/ bladder & bowel involvement. No history of trauma/seizures/loss of consciousness. No history of vomiting/ fever/headache/neck stiffness/dehydration. Patient was healthy until this event. Not a known diabetic/ hypertensive/ old pulmonary tuberculosis, seizures, TIA episodes. He was occasional alcoholic, not a known smoker/drug abuse. His father died of myocardial infarction (no records available), patient has 3 siblings and 2 children all are healthy. At presentation patient's vitals were stable. On neurological examination patient was conscious, coherent, well oriented and higher mental functions were normal. There was hypotonia, power 1/5, diminished reflexes in right upper and lower limbs. Sensory, cranial nerve examination including fundus were normal. Coordination left UL, LL was normal, but could not be done on rt. side. Spine and skull were normal. Pulmonary, cardio vascular and abdominal examinations were normal. The CT head showed hypodensities in the left frontal and parietal lobes. MRI brain confirmed acute infarct in left middle cerebral artery territory. As Baseline investigations (CBP, FBS, lipid profile, LFT, RFT, Urine, PT, aPTT) were normal. The most common cause of stroke in young being cardio embolic, this patient was investigated for source of embolus. Transthoracic echo was done to rule out any valvular heart disease or thrombus or vegetations or infarction. A 24 hour Holter's monitoring no evidence of paroxysmal atrial fibrillation.