Aim: To investigate the prevalence and characteristics of pain syndrome in patients with ischemic stroke against the background of COVID-19 over a 3-month period. Materials and Methods: A total of 34 patients with laboratory-confirmed COVID-19 and ischemic stroke were examined during the acute phase. Pain syndrome onset was studied within 3 months of stroke development, focusing on musculoskeletal pain, central post-stroke neuropathic pain, shoulder pain, and headache. Pain intensity was measured using the Visual Analog Scale and the DN4 questionnaire was applied to determine neuropathic pain. Results: Pain syndrome developed in 75% of patients. Musculoskeletal pain (58.38%) and headache (54.2%) were the most common. More than half of patients experienced a combination of pain types, with musculoskeletal pain and headache frequently co-occurring in one-third of cases. Moderate pain syndrome was the most common (48.7%). Headache positively correlated with COVID-19 severity (r = 0.486, p = 0.005), and shoulder pain positively correlated with stroke severity (r = 0.517, p = 0.002). Conclusions: Identifying the prevalence, structure, and severity of pain syndrome in combined ischemic stroke and COVID-19 cases highlights the importance of timely recognition and management. Effective intervention can prevent pain syndrome chronification, improve functional recovery, and enhance patients' quality of life.