BackgroundPost‐stroke dysphagia is known to have a pronounced effect on mortality and quality of life of stroke patients. Here, we investigate whether this extends to post‐stroke fatigue, a major contributor to morbidity after ischemic stroke.MethodsPatients with acute ischemic stroke (recruited consecutively in the STROKE‐CARD Registry from 2020 to 2023 at the study center Innsbruck, Austria) were examined for dysphagia via clinical swallowing examination at hospital admission. Post‐stroke fatigue was assessed using the Fatigue Severity Scale (FSS) at study specific in person follow‐up visits within the first year after ischemic stroke.ResultsAmong 882 ischemic stroke patients (mean age 72.4 ± 13.5 years, 36.8% females), dysphagia was present in 22.0% at hospital admission and persisted in 16.2% until hospital discharge. Post‐stroke fatigue affected 52.2% of the total cohort during follow‐up and was significantly more prevalent among those with dysphagia (68.4% vs. 49.0%, p < 0.001). The prevalence of fatigue increased with the severity of dysphagia, with the highest proportion (86.7%) in those with severe dysphagia. After multivariable adjustment for other factors associated with post‐stroke fatigue, including age, sex, pre‐stroke disability, cognitive impairment, stroke severity, inability to walk at discharge, and need for antidepressants at discharge, dysphagia remained independently associated with post‐stroke fatigue during the first year after stroke (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.22–3.38).ConclusionsDysphagia is common after ischemic stroke and increases the risk of post‐stroke fatigue. Patient‐tailored measures are warranted to reduce fatigue after stroke and therefore enhance quality of life.