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Background and purpose: Based on the epidemiologic studies, stroke has become one of the fundamental problems in the Middle East. Considering to the role of serum paraoxonase (PON1) in stroke, the present study designed to evaluate the prognostic importance of paraoxonase to arylesterase activity ratio (Para/Aryl) and ratios of the activities to HDL in nondiabetic patients with ischemic stroke. Materials and methods: In this case-control study, 85 patients with ischemic stroke (46 men and 39 women) and 71 control individuals (38 men and 33 women) were enrolled. Paraoxonase and arylesterase activities were determined spectrophotometrically using paraoxon and phenylacetate as the substrates, respectively. Lipid profile was assayed using laboratory kits. The statistical analysis was performed by t-test, Chi-square and Spearman Correlation tests. Results: Compared with the control group, apo A1 levels were significantly decreased (P=0.000). Among three ratios of Para/Aryl, Para/HDL and Aryl/HDL, the greatest statistical difference belonged to Para/Aryl (P=0.016). Para/HDL and Aryl/HDL ratios were higher in patients than controls (P=0.097 and P=0.57, respectively). There was a significant positive correlation (r= 0.268, P= 0.015) between arylesterase activity and apo A1 levels in patients. Conclusion: It concluded that in the evaluation of PON1 status in nondiabetic patients with ischemic stroke, the assay of Para/Aryl and Para/HDL ratios are better indicators of measuring the activity alone. Increased amounts of Para/Aryl, Para/HDL and Aryl/HDL and reduced levels of Aryl may be considered as prognostic biomarkers in the study patients. [ABSTRACT FROM AUTHOR]