Background: People with acute ischemic stroke (IS) have a higher prevalence of occult malignancy. Consensus is lacking, however, on the extent of cancer screening tests that should be offered in this population. We performed a single-center study to review curent cancer screening practices in acute IS. Methods: We reviewed consecutive admissions for acute IS at our institution between January and December 2020. We defined extensive cancer screening as i) a cancer investigation test falling outside Canadian guidelines, or ii) any chest, abdomen or pelvis imaging by CT, TEP/CT or ultrasound. We compared clinical features of people with and without extensive screening with Fisher and Mann-Whitney U tests. Results: Among 171 patients with acute IS, 11 (6.4%) underwent extensive cancer screening. A lower BMI was the only clinical feature associated with extensive cancer screening (p=0.013). Markers that were not associated with extensive screening included age (p=0.479), male sex (p=0.758), cryptogenic etiology (p=1.000), infarctions in multiple vascular territories (p=0.748), hemoglobin (p=0.505), fibrinogen (p=0.162) and C-reactive protein (p=0.442). Conclusions: Common predictors of occult cancer were not associated with more extensive cancer screening in this small sample of IS. Validated clinical prediction models may help clinicians guide cancer investigations in IS.