OBJECTIVES: Stroke has catastrophic consequences resulting in death or disability in 80% of patients and representing a substantial burden on the healthcare system, as well as on patients, family, and society. Stroke is considered as the 2nd cause of burden of disease in Europe and ischemic stroke (IS) represents a high percentage of total strokes. The objective of the present study was to analyze the first year post-stroke burden of IS in Spain.  METHODS: We performed an observational, multicenter, naturalistic and prospective study that included 16 hospitals (stroke units of National Health System hospitals) of 16 Spain regions. We took into consideration consumption of healthcare resources, social burden, productivity lost and health-related quality of live of patient and caregiver during the first year post-stroke.  RESULTS: 321 stroke patients were recruited. Mean age 72 years, 54.8% male. Basal NIH stroke scale was 9.11 and 28.9% presented moderate-high disability. 291 (90.7%) patients presented IS. Overall 1-year cost per IS was 27,596.53€. Direct healthcare costs were 8,623.35€ (31.25%), direct intrahospital healthcare costs supposed 69% (5,926.21€) of these costs. Direct non-healthcare costs were 18,377.75€ (66.59%), of which 16,515.09€ (59.84%) were informal care costs. Productivity lost was 595.43€ (2.16%).  CONCLUSIONS: IS were the majority of total strokes in the study and represent a high burden on healthcare system and society, mainly due to hospitalization and informal care costs. Intrahospital costs were double than the published DRGs in Spain. Other diseases like Alzheimer or dementia represent a lower burden than stroke.