Objectives: Cerebrovascular diseases are the sixth cause of total DALYs in Turkey and the Turkish Social Security Institution (SSI) faces a challenge on reimbursement decisions for treatment. Alteplase is a recombinant human tissue plasminogen activator indicated for treatment of acute ischemic stroke (AIS). Clinical trials have proved efficacy in reducing 90-day disability measured by the Modified Rankin Score (mRS) if administered within 4,5 hours of onset of symptoms. The agent is used as an addition to Standard of Care (SoC). This study aimed at assessing the budget impact of Alteplase from national perspective in Turkey. Methods: A budget impact model assessing the impact with and without use of Alteplase was developed. First, the number of individuals with acute ischemic stroke that are hospitalized and eligible for Alteplase was determined from published data and expert views. Calculations were made for 0 to 1,5 hours after onset, 1,5 to 3,0 hours after onset and 3 to 4,5 hours after onset for both scenarios. Acute ischemic stroke hospitalization costs and the average annual costs after hospitalization were included. Cost estimations were calculated according to mRS score. Literature review and expert opinions were used in calculating the Turkish costs. Results: Number of patients eligible for Alteplase was estimated as 12,950. The budget impact of Alteplase was estimated as 1,490,712 TRY, 1,510,634 TRY, 1,530,555 TRY, 1,550,477 TRY, 1,570,398 TRY for the first, second, third, fourth and fifth years respectively. Conclusions: The burden of AIS on the Turkish healthcare system and unmet need is expected to increase with current ageing trends. The budget impact model revealed that given the efficacy of Alteplase, its budget impact is affordable for the Turkish SSI. In addition to this, reduced disability with the use of Alteplase will reduce resources needed for disabilities and will have an additional budget decreasing impact.