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Background: There is high prevalence of hypertension and diabetes in patients with stroke, and these are also major risk factors for potentially blinding retinal diseases. This study was conducted to determine the prevalence and types of retinal abnormalities in patients with acute stroke in Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria. Materials and Methods: A prospective study of 297 consecutive patients with acute stroke was carried out. All the patients recruited had dilated fundoscopy and those who had retinal abnormalities were referred to the eye clinic for follow-up on discharge. Data analysis was by use of statistical package for social sciences (SPSS version 17), with statistical significance set at a P-value of 0.05. Results: Out of the 275 patients examined, 57.4% (n = 158) had retinal abnormalities. Age-related Macular Degeneration (AMD) predominated (36.7%), followed by cotton wool spots (22.2%) and retinal hemorrhage (16.5%). Hard exudates constituted 12.7%. Neovascularization and microaneurysms formed 5% each, while branch retinal vein occlusion constituted only 1.9%. Sixty-four percent were hypertensive and 24% were diabetic. Conclusion: The prevalence of retinal abnormalities among stroke patients is quite remarkable (57.4%). Routine retinal examination in such patients cannot be overemphasized because it may help to detect potentially vision-threatening retinal disorders. [ABSTRACT FROM AUTHOR]