OBJECTIVES: To estimate the stroke related disease burden in terms of healthcare resource utilization and average per-patient costs among patients with a prior diagnosis of non-valvular atrial fibrillation (NVAF) in India.  METHODS: Data were collected retrospectively in three large multidisciplinary community hospitals in three cities in India.   Medical charts of 400 patients diagnosed with stroke and NVAF from June 1, 2011 to September 1, 2011 were reviewed.  Data abstracted were demographic characteristics, clinical diagnosis, risk factors, comorbid conditions, date of diagnosis/admission, date of discharge, and types of inpatient procedures.  Data regarding outpatient services such as physician visits, laboratory tests, INR monitoring, diagnostic tests, nursing services, and speech/physiotherapy over a three month period post-discharge were obtained via patient follow-up surveys.  Costs associated with inpatient services were obtained from hospital discharge bills and the pricing menu of the three hospitals.  RESULTS: The mean age of patients in the study was 59 (SD 10) and the majority of patients (62%) were male.  Of the 400 patients, 61% had ischemic stroke and about 60% of the patients were moderate to moderate-severe disabled based on the modified Rankin Scale.  The mean length of stay for patients with ischemic stroke was 16 days (SD 4).  The direct medical costs for patients with moderate or more severe ischemic stroke (inpatient and outpatient) over the 3 month follow-up period was Indian rupees, Rs 130,976 (SD 3,913) with inpatient hospital costs accounting for a major portion (Rs 114,202) of the overall costs (per patient).  CONCLUSIONS: The findings of the study indicated that the acute treatment for 3 months post ischemic stroke among NVAF patients imposes considerable economic burden (US $7,138) among patients in India.  As inpatient costs are major cost drivers, clinical efforts should focus on timely management of NVAF induced strokes and use of preventive treatments.