Background: Literature review cited that, stroke is one of the leading causes of death and disability in developing countries. The focus in the acute phase appears to be on the “time is brain” principle. It is important that nurses be able to recognize stroke manifestations as early as they can to ensure that patients can receive appropriate treatment within its time windows. Purpose: The aim of this study is to examine the effect of a designed nursing intervention protocol on neurological outcomes among acute stroke patients at Cairo, Egypt. To achieve this aim, four research hypotheses were formulated. Methods: 60 matched adult male and female acute ischemic stroke patients (30 for each study and control groups) were recruited within a quasi- experimental research design. National Institutes of Health Stroke Scale modified Rankin scale, Gugging Swallowing Screen Test and the Hemodynamic Follow up Data Sheet were used to collect data pertinent to this study. Patients were assessed three times; preintervention, post interventions and pre-discharge to examine the stated research hypotheses. Results: Hypothesis one can be supported as a statistical difference was put into evidence between the study and the control groups (χ2: 5.27, P value: 0.00) as regards to the severity of stroke. As well, hypothesis two can also be supported as a significant statistical difference was found between the study and the control groups (χ2: 4.49, P value: 0.01) regarding degree of disability. In addition, hypothesis three can’t be supported in relation to hemodynamic parameters including temperature, pulse, blood pressure and random blood sugar. As regards to risk for aspiration, a significant statistical difference was found between both groups (χ2: 5.79, P value: 0.02) so, hypothesis four can be also supported. Conclusion: Neurological outcomes of acute ischemic stroke patients can be improved when applying a designed nursing intervention protocol through reducing severity of stroke, level of disability and a risk of aspiration.