This chapter gives practical advice for the hospital assessment of stroke patients, both on admission and during their hospital stay. This includes clinical evaluation at the bedside, basic laboratory investigations, and non-invasive brain and vascular imaging. The purpose of assessment is to initially assess clinical state, try to determine aetiology, and guide appropriateness for acute management strategies such as thrombolytic therapy for ischaemic stroke. Stroke mimics can usually be identified at this stage, should the pre-hospital survey have missed it. Progress post admission needs to be monitored and regularly assessed and this includes further clinical assessment, more specialised neurovascular imaging, and other tests (discussed in other chapters).