Objective: to analyze individual clinical and instrumental characteristics of ischemic stroke (IS) depending on patients’ compliance to antihypertensive therapy. Materials and methods. Complex clinical and neurological examination of 178 patients: 96 men (53.9%) and 82 women (46.1%) aged 37 to 87 years with acute IS and documented history of arterial hypertension was provided. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). The diagnosis of hypertension was based on data from clinical, instrumental examination and medical documentation. Adherence to antihypertensive therapy (AHT) was considered in 3 options: constantly taking AHT, taking AHT time to time, did not take AHT. Results. Severity of IS by the NIHSS was 10.5±0.42 points, which corresponds to a stroke of moderate severity. A mild stroke more often occurred in patients with constant AHT — 28.1%, while a severe stroke occurred more often in patients without AHT at all — 34.1%. Ischemic foci larger than 15 mm were most common in patients without AHT — 37 (42%). Left hemisphere localization of stroke occurred more often in patients with constant AHT and without AHT — 17 (53.1%) and 44 (50%), respectively. Conclusions. Half of the patients (50.0%) with arterial hypertension and IS did not take AHT. Recurrent strokes or transient ischemic attacks were most common in intermittent or absent AHT groups — 34.5 and 40.0%, respectively. Severe strokes and the size of the ischemic focus more than 15 mm more often observed in group of patients without AHT. There was no significant difference between the frequency of foci up to 10 mm and the level of adherence to AHT. The relationship between adherence to AHT and localization of stroke wasn’t found.