Introduction: Stroke remains the second leading cause of death worldwide, after ischemic heart disease. Lacunar infarcts are small deep infarcts ranging from 2 to 20 mm in size resulting from occlusion of a penetrating artery which accounts for approximately 25% of all ischemic strokes. The present study was undertaken to study the incidence of lacunar infarcts in patients with acute ischemic stroke and its correlation with carotid stenosis. Methods: This study was performed at the Department of Medicine at a tertiary-care hospital in Amritsar, Punjab, in 50 patients presenting with acute ischemic stroke with or without lacunar syndrome. All patients were diagnosed using diffusionweighted imaging (DWI) on magnetic resonance imaging (MRI) of the brain. Carotid artery stenosis was measured with duplex ultrasound. Results: Patients with acute ischemic stroke had a mean age of 61.36 ± 11.36 years. About 40% of the patients had lacunar infarcts with a higher frequency in male patients (64% vs 36%). There was no significant difference found in the incidence of hypertension (85% vs 70%), diabetes (20% vs 13.3%, p value = 0.529), alcohol drinking (20% vs 16.67.0%, p value = 0.764), smoking (23% vs 10% p value = 0.318), and carotid artery stenosis (35% vs 43.3%, p value = 0.828) between lacunar and non-lacunar infarct patients. Conclusion: The difference in the incidence of potential risk factors such as hypertension, diabetes mellitus, alcoholism, smoking, and dyslipidemia was found to be statistically insignificant between lacunar and non-lacunar infarct groups. Carotid stenosis did not show any significant difference in the lacunar and non-lacunar infarct groups. The findings in our study are consistent with the hypothesis that severe carotid artery stenosis in lacunar infarction is an incidental finding.