Both hypertension (HT) and chronic kidney disease (CKD) are associated with an increased risk of cardiovascular diseases including stroke. Our objective was to examine, using the data of Fukuoka Stroke Registry (FSR), the association between these risk factors and the clinical manifestations and outcome of acute ischemic stroke patients. 1,410 consecutive patients with cerebral infarction were enrolled. HT and CKD were observed in 74.0% and 32.1% of the patients with cerebral infarction, respectively. The patients with HT (HT group) had higher frequencies of diabetes and dyslipidemia than those without HT (non-HT group). The frequency of atherothrombotic infarction in HT group was higher than in non-HT group. Severity and activity of daily living (ADL) were similar between HT and non-HT groups. On the other hand, the patients with CKD (CKD group) had higher frequency of cardioembolic stroke than those without CKD (non-CKD group). NIH stroke scale of CKD group was higher than non-CKD group and ADL of the patients with CKD was worse than those without CKD. Thus, HT and CKD may have a different impact on ischemic stroke.