Background: The burden and outcome of stroke in indigenous populations is less well understood. This review evaluates ischemic stroke outcomes in indigenous populations as compared to the general population in the context of recent advances in ischemic stroke therapy. Methods: The OVID Medline and EMBASE databases were searched for this review. Clinical outcome was measured using standardized outcome scale (eg. mRS) at 90 days following stroke intervention in indigenous as compared to non-indigenous adult populations. Results: 897 studies were identified, with 4 studies included in the final analysis. A total of (n=68895) patients were included who underwent thrombolysis. Study populations from Australia, New Zealand, United States and Canada comprised of (n=2012) indigenous patients. Mortality was significantly higher in indigenous populations as compared to non-indigenous (Odds Ratio-1.28, 95% CI-1.12; 1.46). The odds ratios of atrial fibrillation (1.26, 95% CI-1.12;– 1.41), diabetes (1.43, 95% CI- 1.27; 1.62), hypertension (1.33, 95% CI- 1.17; 1.51) and IHD (0.71, 95% CI- 0.62; 0.81) in indigenous patients was significantly higher than in non-indigenous patients. Conclusions: Indigenous populations undergoing stroke therapy are at a significantly increased risk of mortality as compared to non-indigenous populations. Comorbidities including diabetes, atrial fibrillation and hypertension are more prevalent in indigenous populations.