Background: Stroke is characterized by sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Early diagnosis and treatment in acute stroke are crucial in terms of survival and disability. Factors associated with early arrival may vary according to the characteristics of the hospital. Late presentation to hospital after onset of stroke affects the management and outcomes of the patients. Aim & Objective: The objective of the study is to enumerate the common factors involved in delay or early presentation of patients after a stroke to a tertiary care hospital in a rural area. Materials and Methods: The study was a prospective, time-bound, hospital-based, observational study. The study was conducted with a sample size of 112 patients who presented to the EMERGENCY DEPARTMENT with features suggestive of acute stroke during the period January 2018 – June 2019 Results: The mean age of patients presented to the hospital with a stroke is 56 years. There is a male preponderance of about 75%. Three-fourths of the patients presented directly to tertiary care. Weakness and slurring of speech have been significant complaints for arrival. 16% of the population presented in the universal window period, i.e., 0-3 hours., whereas 20% of the people who showed up in 3-4.5 hours have satisfied ECASS lll criteria. Distance is not altering the presenting time to the hospital. Conclusions: The current study showed that people with awareness of the disease presented early within the window period. There is a need for medical education to the primary care physicians and outreach to the people to decrease the time of presentation to the hospital. Due to well-versed transport facilities, there is no issue with the Emergency Medical Services irrespective of the distance from the patient home to the hospital.