Objective. To study the characteristics of neuropsychological status on the basis of functional asymmetry in patients who have suffered ischemic stroke (IS). Materials and methods. A total of 92 patients with IS of different pathogenetic subtypes (atherothrombotic, cardioembolic, lacunar) were studied. Results. We report here the fi rst description of neuropsychological status in IS patients with consideration of functional asymmetry of the brain. When foci of IS were located in the left hemisphere in right-handed patients, the system-forming factor consisted of the parameters of expressive speech and counting functions, while that in left-handed patients consisted of measures of expressive speech and praxis function. In patients with right-hemisphere strokes, the system-forming factor in right-handed patients with right-hemisphere IS foci consisted of the reading function, while in left-handed patients this applied to praxis and counting functions. Conclusions. The results obtained here provide grounds for constructing programs for restorative therapy after IS.