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Objectives: Understanding of the mortality and cause of death after ischemic stroke is important in helping hospitals targeting potential preventable and treatable medical conditions, and optimizing management strategies. The purpose of the study was to investigate California-specific mortality and cause of death following hospitalization for acute ischemic stroke based on patient demographic characteristics in a large patient population.Methods: Adult patients admitted to California-licensed acute care hospitals for acute ischemic stroke from 2013 to 2014 were included in the study. Data were from the California patient discharge data, linked to California death certificate records (2013 to 2014) using patient’ social security number as the common identifier. Mortality rates and causes of death based on patient gender, age, race, and expected payer were evaluated.Results: Of 73,982 patients, 20.8% (15,428) had died by the end of study period. Nearly half of these deaths occurred within 30 days of admission, and a quarter of deaths happened within 7 days. Female, age >= 80, and white patients had a significant higher mortality rate. The cumulative all-cause mortality rate was 10.0% at 30 days, and 19.3% at 1 year. Over 70% of the patients died from diseases of the circulatory system, while stroke contributed to 43.4%. Deaths within 7 days were primarily caused by stroke as well as fibrillation and flutter. Female, age >= 80, white and Medicare patients tended to die from diseases of the circulatory system while male, younger, black and Medi-Cal (California’s Medicaid program) patients were more likely died from cancer.Conclusion: Mortality and cause of death varied significantly by patient demographic characteristics. Effective interventions and preventions based on patient demography as well as better management of stroke and fibrillation & flutter in first week may reduce the stroke mortality rates and improve hospital quality.