Background <p>Ischemic strokes are a leading cause of disability. While traditional risk factors including hypertension and diabetes are common, younger adults may experience strokes from less typical causes, such as infections. This case report presents an acute ischemic stroke in a young adult linked to Epstein–Barr virus infection, emphasizing the potential role of viral infections in stroke risk.</p> Case presentation <p>This is a case of a 36-year-old African-American female who presented with sudden-onset right-sided weakness and aphasia. Computed tomography angiography revealed a left middle cerebral artery occlusion; patient received thrombolysis therapy and endovascular thrombectomy. A comprehensive workup excluded other stroke risk factors such as hypercoagulability and cardio-embolism. Blood tests showed an acute Epstein–Barr virus infection, which was treated with supportive care. Patient received rehabilitation and secondary stroke prevention treatment, resulting in full recovery.</p> Conclusion <p>This case contributes to growing evidence suggesting that viral infections, including Epstein–Barr virus infection, may be an underrecognized risk factor for ischemic stroke in young adults. It highlights the importance of considering viral causes in the differential diagnosis of ischemic strokes, particularly in patients without traditional stroke risk factors, and suggests that future research should explore viral-induced vascular injury as a potential stroke mechanism.</p>