The aim of the study was to investigate and compare clinical characteristics, sex differences and in-hospital mortality between stroke patients with and without diabetes mellitus (DM). All patients admitted to Al- Watani Governmental Hospital for 12 consecutive months and diagnosed with acute stroke were included in the study. Demographic data, clinical characteristics and in-hospital mortality were compared between diabetic and nondiabetic stroke patients. Pearson χ2-test and Student’s t-test were used on univariate analysis. Data were analyzed using SPSS 16. There were 186 stroke patients, mean age 69.09±0.9 years, with positive DM history recorded in 48.9% of male and 45.2% of female patients. Diabetic stroke patients were significantly younger (66.8±10.99 vs. 71±10.52 years; P=0.009) and had a higher proportion of ischemic heart disease (11.9% vs. 3.9%; P=0.04) compared to nondiabetic stroke patients. Inhospital mortality accounted for 39 (21%) patients, including 23 (27.4%) diabetic and 16 (15.7%) nondiabetic stroke patients (P=0.051). Univariate analysis of diabetic stroke patients based on sex showed male patients to have significantly more hemorrhagic strokes (P=0.04), recurrent strokes (P=0.003) and in-hospital mortality (P=0.034) compared to female patients. There was no sex difference in nondiabetic stroke patients. Analysis of diabetic stroke patients based on vital status indicated that in-hospital mortality was significantly associated with sex (P=0.034), type of stroke (P=0.006) and recurrent stroke (P=0.01). None of the variables was significantly associated with mortality in nondiabetic stroke patients. In conclusion, diabetic patients have different clinical characteristics, show sex differences and in-hospital mortality differences compared to nondiabetic patients after acute stroke.