Background: Stroke is a sudden and often devastating injury to the central nervous system caused by blood flow disruption to the brain, leading to long-term consequences such as neurological impairments. It is a major cause of disability and mortality among adults. Various studies have highlighted caregiver (CG) stress, but none have compared stress levels in hospital and home environments. Our study aims to explore factors influencing caregiver stress in both settings.Aim and objective: To identify the most common source of stress among those who care for acute stroke survivors as well as the overall experiences that caregiver has in hospital and home settings. Methodology: An observational study was conducted at Sri Ramachandra Hospital on caregivers of first-time stroke survivors. Demographic data and stress levels were assessed using MCSI on discharge day and 10 days post-discharge. Reasons for stress were identified through open-ended questions.Results: Quantitative data included mean and standard deviation for 60 participants, consisting of 44 males and 16 females with an average age of 57.35 ±10.78. Among the caregivers of acute stroke patients, 60 individuals were surveyed, including 19 males and 41 females with an average age of 46.23±11.79. The Modified Caregiver Strain Index (MCSI) with thirteen questions rated stress levels at home and in the hospital. Results showed higher stress levels at home for components such as sleep disturbance (90%) and caregiving inconvenience (86.6%), while hospital stressors included family adjustments (61.6%) and financial strain (95%). Overall, caregivers experienced different stress factors depending on the location.Conclusion: Study shows caregiver stress increases based on patient’s impairment, needs, and caregiver's understanding of the condition. Stress levels vary between male and female caregivers, with modifiable and non-modifiable stress factors identified. Strategic programs are needed to enhance rehabilitation effectiveness, reduce caregiver stress, and enhance quality of life for both patient and caregiver.