This study aimed to investigate the effect of serum albumin at admission, measured within 24 h after stroke onset, on the functional outcome in ischaemic stroke patients. The medical records of 76 first-ever hemiplegic ischaemic stroke patients were reviewed. Collected data included age, sex, initial stroke severity, cerebrovascular risk factors, lesion-related variables, aetiologic subtype of stroke and serum albumin at admission. The functional outcome was measured by functional independence measure (FIM) and modified Barthel index (MBI). Serum albumin at admission and initial National Institutes of Health Stroke Scale (NIHSS) score were correlated with the functional outcome, respectively. Serum albumin at admission was an independent predictor of MBI gain on multiple regression analysis. Serum albumin at admission would be a useful predictor of the functional outcome and trials for the correction of hypoalbuminaemia from the acute stage would be helpful to decrease the risk of poor outcome in ischaemic stroke patients.