Objectives: Despite the high burden of strokes globally and among people of African origin in particular, there are few available data on stroke in most countries of sub-Saharan Africa (SSA), including Zambia. The aim of this study was to describe the characteristics and outcomes of stroke in adult Zambian patients admitted to the University Teaching Hospital (UTH) in Lusaka. Methods: The study was conducted at the UTH, which is the only tertiary hospital in the country, from July to December 2010. Stroke was confirmed by neurological examination and CT scan of the brain. Participants were assessed for risk factors and severity of stroke. Outcome measures included in-hospital stroke mortality and disability (modified Rankin score and Glasgow outcome scale on discharge). Results: A total of 250 consecutive stroke patients were included in the study. Of these 162 (65%) patients had ischemic and 88 (35%) hemorrhagic strokes. The mean age was 55 ±18years. Hypertension was most common risk factor for both strokes. Other risk factors included: alcohol intake (32.6%), previous stroke (23.6%), family history of stroke (23.2%), HIV infection (25.4%), hypercholesterolemia (14%) andtobacco smoking/sniffing (13.4%). In-hospital stroke mortality was 40%. Factors independently associated with mortality were female sex, pneumonia, Glasgow Coma Scale (GCS) 8 and stroke severity at admission. Conclusions: Stroke in Zambian patients occurs at a relatively young age and frequency of intracerebral hemorrhage is higher than that reported in developed countries. Hypertension is common risk factor for both types of strokes. Family history of stroke is one of important risk factor. In-hospital stroke mortality is high at UTH. HIV infection is independently associated with ischemic stroke.