Diagnostic workup has changed dramatically over the last 3-4 decades . Since 1990s, procedures like transesophageal echocardiography, hypercoagulability testing and resonance are included within the systematic diagnostic protocol for stroke in young adults. a big percentage of patients still be diagnosed with undetermined etiology even after extensive evaluation. ischemic stroke in young adults (15-45 years) is comparatively frequent, accounting for quite 10% of all first ischemic strokes). Its causes are heterogeneous and while it generally features a good prognosis, it's a big socioeconomic impact, including functional deficits and financial costs. An accurate etiological diagnosis is crucial for preventing new episodes and extra functional deficits. Currently, the foremost frequent causes of ischaemic stroke in young adults are cardioembolism, premature atherosclerosis, dissection of extracranial arteries, migraine, drugs and hypercoagulable states . However, it's not always been like this, as previously undetermined etiology was far and away the foremost prevalent. Although still common, undetermined etiology is now less frequent as a result of diagnostic improvements