Background. Stroke is the second-leading global cause of death behind heart disease, accounting for 11.8 % of total deaths worldwide. However, currently, there are not enough published prospective hospital-based cohort studies that report and analyze outcomes of thalamic stroke. The purpose of this study is to determine the features of acute thalamic stroke outcomes in a prospective hospital-based cohort study, providing a comprehensive clinical and neuroimaging analysis of the treatment results and assessing the outcomes of acute thalamic stroke. Materials and methods. We prospectively recruited 319 acute stroke patients, admitted within 24 hours from the onset of the stroke symptoms to the Neurological Center at an academic hospital (Oleksandrivska Clinical Hospital) in Kyiv, Ukraine. Comprehensive neurological, clinical, laboratory, ultrasound, and neuroimaging examination was performed in all patients. Results. MRI/CT-proven thalamic stroke was diagnosed in 34 (10.6 %) out of 319 persons, forming a study group: 22 patients (average age 61.9 ± 10.2 years) were diagnosed with an acute isolated ischemic thalamus infarction; 12 (average age 59.0 ± 9.6 years)-with an acute thalamic hemorrhage. Specific neurological outcomes of infarctions and hemorrhages in different thalamic territories were analyzed, compared, and described.