BACKGROUND Stroke is a global health problem. Platelet activation & aggregation are critical in pathogenesis of acute ischemic stroke. The mean platelet volume (MPV) and platelet distribution width (PDW) are laboratory markers associated with platelet function and activity. Increased values in thromboembolic disease is reflected as an important risk factor. We wanted to assess the severity of acute ischemic stroke according to modified Rankin scale and determine the value of mean platelet volume and platelet distribution width. We also wanted to establish the correlation between mean platelet volume, platelet distribution width with the severity of acute ischemic stroke and correlate the value of mean platelet volume, platelet distribution width with other risk factors for stroke. METHODS A prospective study was undertaken among patients admitted in ESIC Medical College & PGIMSR from January 2017 to June 2018. Study comprised of around 150 cases of acute ischemic stroke without previous thrombotic events. Severity of ischemic stroke was assessed by the Modified Rankin Scale. Patients were divided into 2 groups based on Rankin score (Group 1: Score 0-2, and Group 2: Score 3 or more). Blood samples were taken to measure MPV and PDW. RESULTS MPV and PDW were significantly elevated in patients who suffered a severe stroke defined as modified Rankin score of 3 to 6. Patients with higher MPV had worse outcome at the end of one week. After controlling for the risk profile associated with ischemic stroke in the multivariate logistic regression model, the effect of MPV in ischemic stroke remained statistically significant. CONCLUSIONS MPV and PDW can be considered as laboratory markers for the risk of acute ischemic stroke. The MPV is associated with ischemic stroke severity and has a high value for discriminating severe from mild ischemic stroke.