['Infective endocarditis (IE) is still associated with high morbidity and mortality. The impact of pre-operative stroke on mortality and long-term survival is controversial. In addition, data on the severity of neurological disability due to pre-operative stroke are scarce. We analysed the impact of pre-operative stroke and the severity of its related neurological disability on short- and long-term outcome.', 'We retrospectively reviewed our data from patients operated for left-sided IE between 01/2007 and 04/2013. We performed univariate (Chi-Square and independent samples t test) and multivariate analyses.', 'Among 308 consecutive patients who underwent cardiac surgery for left-sided IE, pre-operative stroke was present in 87 (28.2\xa0%) patients. Patients with pre-operative stroke had a higher pre-operative risk profile than patient without it: higher Charlson comorbidity index (8.1\xa0±\xa02.6 vs. 6.6\xa0±\xa03.3) and higher incidence of Staphylococcus aureus infection (43 vs. 17\xa0%) and septic shock (37 vs. 19\xa0%). In-hospital mortality was equal but 5-year survival was significantly worse with pre-operative stroke (33.1\xa0% vs. 45\xa0%, p\xa0=\xa00.006). 5-year survival was worst in patients with severe neurological disability compared to mild disability (19.0 vs. 0.58\xa0%, p\xa0=\xa00.002). However, neither pre-operative stroke nor the degree of neurological disability appeared as an independent risk factor for short or long-term mortality by multivariate analysis.'] Do pre-operative stroke and neurological disability independently affect short- and long-term mortality in infective endocarditis patients?