BACKGROUND: Knowing the magnitude of a problem is the first step to improving it, and quantifying the health- related quality of life (HRQOL) allows us to do it with respect to stroke. To identify the HRQOL in patients with ischemic stroke and its affecting factors, and compare it with other clinical and functional scales. METHODS: A consecutive series of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) was recruited. Their HRQOL and utilities were assessed using the EQ-5 Dindex-which evaluates the health profile of an individual in five dimensions (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression) and three levels (no problem, some/moderate problems, and extreme problems)-at 1 year after stroke. The Modified Rankin Scale (MRS), Barthel Index (BI), and NIH Stroke Scale (NIHSS) were used to measure clinical and functional statuses. The EQ-5D index and the clinical and functional statuses were compared by clinical parameters, and the relationships among those scales were examined. Additionally, the EQ-5D index in the patients was compared with that in age- and sex-matched healthy controls. RESULTS: Among 538 patients with AIS or TIA, 465 patients (males, 59.8%; age, 65.3+/-11.8 [mean+/-SD]; TIA, 7.7%; and initial NIHSS, 4.5+/-5.1) were evaluated. The EQ-5D index and the clinical and functional statuses were clearly aggravated by age, but did not differ with most of the risk factors. The EQ-5D index was strongly and significantly correlated with scores on the MRS, BI, and NIHSS. The EQ-5D index was lower in patients (especially older ones) than in healthy controls. CONCLUSIONS: This study shows that the EQ-5D is a feasible and valid tool for measuring HRQOL in patients with AIS or TIA.