Background: The synchronous occurrence of acute ischemic stroke and acute myocardial infarction is an extremely rare condition. The causes, treatment and mortality rate in these cases is still unclear. Methods: We conducted on the literature review and analyzed, causes, type of myocardial infarction, the culprit cerebral artery, causes, modified ranking scale at discharge, treatment options , mortality rate and cause of mortlity. Results: We identified 96 cases of synchronous occurrence of acute ischemic stroke and acute myocardial infarction with mean age 63.8 ±12.3 years. Male 60 patients (62.5%). The most common risk factors of The synchronous occurrence of acute ischemic stroke and acute myocardial infarction was hypertension 45 (46.8%) followed by diabetes mellitus 26 (27.7%), the most common rhythm abnormality was atrial fibrillation 21 (21.9%), myocardial infarction type the most type was anterior ST segment elevation myocardial infarction (38.5%), The most common culprit artery in brain was left middle cerebral artery (31.2%). The causes were embolic events, Atherosclerotic, Hyper coagulant states and aortic dissection. The modified Rankin Score (mRS) was measured in 74 patients at hospital discharge. During hospitalization 25 (33.8 %) patients died. Conclusion: synchronous occurrence of acute ischemic stroke and acute myocardial infarction prognosis is very poor about one third of patients died during hospitalization time. The most causes of the patient were cardiac causes 18 (75%) such as ventricle tachyarrhythmias, cardiac Tamponade, aortic dissection, ventricle septal rupture, or sudden death Keywords: Acute stroke, myocardial infarction, percutaneous coronary intervention (PCI), mechanical thrombectomy (MTE), modified ranking scale (mRS).