Background: Stroke in the young is particularly tragic because of its potential for life time disability. Although a large number of studies have been published Worldwide. Very few have looked at etiologies in the youth of the Middle East,and none have focused on Oman. Methods: Retrospective,single center study,carried out at the Royal Hospital in Muscat. Chart review identifying all patients under 50 years of age admitted for acute stroke from 2009-2014. We analyzed the detailed history,examination and brain imaging (CT or MRI) for each case. We identified 588 young patients,163 of these were excluded due to other diagnosis or absence of neuroimaging (CT or MRI). Results: Out of the 425 stroke cases,67.3% were men. IS occurred in 69.6% compared to 30.4% for HS. Hypertension was the number one risk factor for both IS and HS,with a prevalence 50.7% and 60.5% respectively. DM was the second leading risk factor,with a prevalence of 32.1% in IS and 27.1% in HS. Underlying etiologies were identified in only 35.5% of cases in IS and 29.5% in HS.Cardiac etiology and vasculopathy were commonest for IS. Aneurysm was the main underlying etiology for HS. Conclusions: IS was more frequent than HS.Hypertension and DM were the leading risk factors for both stroke subtypes. Cardioembolism and vasculopathy were the main etiologies for IS.Cerebral aneurysm for HS.