Objective. To compare risk factors of the first hemispheric ischemic stroke in young, middle and old age groups. Material and methods. One hundred and thirteen patients with first hemispheric ischemic stroke confirmed by CT/MRI were examined. The patients were divided into 2 groups: young and middle-aged (51 patients, 24 women, 27 men, mean age 49.8±5.2) and advanced-aged (62 patients, 30 women, 32 men, mean age 76.4±7.5). The frequency and duration of the following risk factors for ischemic stroke, including arterial hypertension, ischemic heart disease and arrhythmias, diabetes, smoking, family history of myocardial infarction and/or stroke, body mass index, acute emotional stress before the onset of the disease, were compared. Results of echocardiography, Holter and blood pressure monitoring, total cholesterol, low and high-density lipoproteins, triglycerides and blood glucose were analyzed. Results. In young and middle-aged patients, an increased variability of blood pressure, acute emotional stress before the onset of stroke, a family history of cardiovascular and/or cerebrovascular disease, a decreased level of high-density lipoproteins, silent myocardial ischemia on Holter monitoring, mitral and tricuspid valve prolapse, minor abnormalities of the heart were more frequent than in the advanced age group. Conclusion. There are age-related differences in the spectrum and frequency of risk factors in patients with first hemispheric ischemic stroke. This fact should be taken into account in stroke prevention programs in various age groups.