Background: Body position generally effect on respiratory and stroke disease. Stroke morbidity increased by inappropriate position during the early recovery phase. Aim: To evaluate the effect of changing selected body positions on oxygen saturation among patients with acute stroke. Research design: Quasi-experiment research design applied in this study. Sitting: the study carried out at the stroke intensive care unit of the Neurological Department of Aswan University Hospitals. Sample: 60 patients with acute stroke within 24-48 hours following mild to moderate and severe stroke allocated a randomized sequence of four positions. One hour spent in each position. SaO 2 was recorded each15 minutes by pulse oximetry with a finger probe. Tools of data collection: structured interview questionnaire sheet, Glasgow Coma Scale, the Scandinavian stroke scale, and oxygen saturation monitoring record. Results: mean score of SaO 2 at 2 nd 15 min, 3 rd 15 min, 4 th min, and mean SaO 2 of one hour at the semi-sitting position was higher than different positions (Supine position, Right side position, and Left side position) with statistically significant differences with p-value .008, .05, .002, and .019 respectively, the semi-sitting position was the best position of all position. Conclusion: the study finding concluded that the semi-sitting position is the best position than other positions in improving oxygen saturation after one hour from positioning among stroke patients. Recommendation: use a semi-sitting position and implicate this positioning strategy in the future to improve arterial oxygen saturation in acute stroke patients.