Objective To observe the incidence of different cardiac arrhythmia in patients with acute stroke. Methods 24 hour dynamic electrocardiogram recordings were performed in 124 patients with acute stroke. Results Cardiac arrhythmia was found in all cases, supraventricular tachyarrhythmia appeared in 31 cases, while 72 cases occurred serious cardiac arrhythmia, 38 cases suffered from more than one type of arrhythmia. Conclusions There are high incidence of arrhythmia, esp. serious cardiac arrhythmia in the patients with cerebrovascular diseases. It is suggested that DCG should be used routinely in monitoring the patients with acute stroke, for diagnosing and treating the patients exactly.