A total of 4,279,921 (weighted) patients (>18 years) were diagnosed with AIS. Among them 16,015 (0.37%) carried a diagnosis of IE at presentation. IV tPA administration rates were 4.87% (n=208,056) among non-IE and 4.24% (n=679) among patients with IE. There was a higher prevalence of ICH in IV tPA-treated patients who had IE (23.2% vs. 21.0%, p=0.51). However, IV tPA use was associated with a significantly higher mortality in the non-IE cohort vs. IE cohort (8.5% vs. 4.2%, p=0.002). Similar to IV tPA, MT in patients with IE had a higher prevalence of ICH (9.4% vs. 6.1%, p=0.115). However, MT use was associated with a significantly higher mortality among those with IE vs. non-IE group (4.23% vs. 2.39%, p=0.019). After adjusting for confounders, MT in IE-patients was associated with a 5.3 times higher odds of death (p=0.0001), while tPA use was not (0.79, p=0.38).