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Abstract Stroke is a main reason for long term adult disability through the world (Ward, 2017). chronic affective symptoms like mood disturbance, pain and fatigue has a significant impact on quality of life and are more difficult in management (De Doncker et al., 2017). In Egypt, stroke prevalence is high ranging from 560 to 920 per 100 thousand (Abd-Allah et al., 2018), and the incidence of stroke annually is approximately 150,000–210,000; increasing by around 9.6% from 1990 to 2019 (Aref et al., 2021, Shahbandi et al., 2022). Post-stroke fatigue (PSF) is a common and disabling consequence of stroke (Nadarajah and Goh, 2015). PSF affects 25-85% of stroke patients, the wide range is due to different scales in studies (Cumming et al., 2016). PSF is associated with a lower quality of life, a decreased likelihood to return to work, and a higher risk of death, with about 40% of stroke survivors report fatigue as their worst or one of their worst symptoms (Andersen et al., 2012, Kirchberger et al., 2022, Pedersen et al., 2022). We conducted this Prospective cohort study to assess the prevalence of poststroke fatigue and to investigate its biological, clinical and radiological predictors in stroke survivors admitted in neurology department, Suez Canal University Hospital. One hundred and forty-four stroke patients of both ischemic and hemorrhagic stroke who aged from 18 to 70 years were included in the study. Patients who had severe stroke, or significant dysarthria or aphasia, or delirious patients, or had previous history of stroke were excluded from the study along with patients had impaired liver or renal functions, anemic |