OBJECTIVES:  To estimate medical resource use and direct medical cost of patients with non-cardioembolic ischemic stroke (IS) in Beijing, China. METHODS:  This was a retrospective cohort study using Beijing Urban Employee Basic Medical Insurance database. Patients (≥18 years old) hospitalized with a primary diagnosis of non-cardioembolic ischemic stroke (index event) between Oct.01 2012 and Dec.31 2014 were included. High-risk patients were further identified by Essen Score ≥ 3, with absence of smoking information in the database. 2-year before and 1-year after index date was observed to analyse the baseline characteristics and direct medical cost. . SAS 9.2 was used to conduct the statistical analysis. RESULTS: A total of CONCLUSIONS:  Patients with ischemic stroke suffered considerable economic burden. The major component of the medical cost was medication cost while the secondary prevention medications for ischemic stroke only accounted for a small proportion of it.