We investigated the predictive potential of platelet indices, Neutrophil Lymphocyte rario (NLR) and lymphocyte Monocyte ratio (LMR) in Acute ischemic stroke (AIS) patients Treated with rtpa. In the meta analysis it was revealed that in the AIS patients platelet count (PC) were lower and the mean platelet volume (MPV) was higher compared to the control group. In prospective study a combination of high NLR and low LMR 24 hours post thrombolysis independently predicted poor outcome within 90 days. Our findings suggested that PC, MPV and combination of NLR/LMR can be used to improve prognostic accuracy and guide treatment decisions