Abstract Background Ischemic strokes (IS) occurring in patients taking non-vitamin K antagonist oral anticoagulants (NOACs) are becoming increasingly more frequent. We aimed to determine the clinical, echocardiographic, and neuroimaging markers associated with developing IS in patients taking NOACs for atrial fibrillation. Methods From a quaternary care center, clinical/radiologic data were collected from consecutive NOAC users with IS and age-matched controls without IS.