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Background: Stroke is the second leading cause of death and the third leading cause of disability across the world. The understanding of stroke in a clinical setting is what we wanted to achieve as there is a very scarce amount of data present in India when it comes to vascular diseases, especially the rural part of India. Aims and Objectives: The aims of the study were (1) to study the clinical profile of stroke and (2) to study the prescribing pattern of drugs in stroke patients attending a tertiary care hospital in rural Telangana. Materials and Methods: A retrospective case sheet-based study was conducted in a tertiary care institute from January 01, 2015, to July 31, 2016. The approval for the study was obtained from the Institutional Ethics Committee. Results: Of the total 155 stroke case sheets analyzed, the majority had an ischemic stroke (91.61%). The incidence of stroke was more in the 50–70 years age group with male preponderance. The most commonly involved area and presentation were capsuloganglionic region and hemiparesis (75.48%), respectively. About 97.89% of ischemic stroke patients were treated by antiplatelet agents (aspirin – 66.2% and clopidogrel – 31.69%). All the hemorrhagic stroke patients were managed by mannitol. The most commonly prescribed antihypertensives medications were calcium channel blockers (55.45%). Conclusion: Ischemic stroke is the most common type of stroke with increased occurrence in the age group of the 5th–7th decade and male preponderance. Capsuloganglionic infarction or hemorrhage was the most common radiological finding with hemiparesis being the most common presentation. Antiplatelet agents (aspirin and clopidogrel) and mannitol were prescribed in ischemic and hemorrhagic stroke, respectively.