Introduction <p>In the working population, diminished productivity increases the economic burden of ischaemic stroke. This study aimed to estimate costs of paid productivity losses per modified Rankin Scale (mRS) score at different time points up to two-years post-stroke.</p> Patients and methods <p>Data from a multicentre cross-sectional study on post-stroke costs were utilised. Only patients with a pre-stroke professional activity were included in this study. Patients participated in a telephone mRS-interview and returned a questionnaire on paid productivity loss due to absenteeism and presenteeism in the preceding three months. Records were categorised into three-month, one-year, and two-year post-stroke time points based on the interview date. Costs of paid productivity loss were calculated using the human-capital approach (HCA) and friction cost method (FCM). Bootstrapping was combined with multiple imputation to derive mean costs per time point and mRS score (0, 1, 2, and 3–5).</p> &#xa0;Results <p>Out of 1106 records, 280 respondents had a pre-stroke professional activity. Costs of paid productivity loss according to both the HCA and FCM ranged from €8980 (mRS 1) to €17,620 (mRS 3–5) in the first three months post-stroke. At one- and two years post-stroke, cost estimates according to the HCA were very similar to those at three months, while costs according to the FCM were significantly lower (0-775 euro at one year and 113–1884 euro at two years post-stroke).</p> Discussion <p>Costs of productivity loss following ischaemic stroke in the working population are substantial and rise with higher mRS scores.</p> Conclusion <p>These estimates may be used to inform health economic evaluations. </p>