Ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. Gastrointestinal mucosal damage not only induces local and systemic inflammatory reactions but may also result in multiple organ dysfunction syndrome. We studied whether the changes in serum ghrelin and small intestinal motility occur in cerebral ischemia. The focal cerebral ischemia rat models were produced by the middle cerebral artery occlusion (MCAO) method. The MCAO group was further equally divided into five subgroups at 3, 6, 12, 24, and 48 hr, and the sham operated rats were used as controls. Serum ghrelin level was analyzed using enzyme-linked immunosorbent assay, and small intestinal motility was measured by methylene blue staining. The ileum tissue was examined by light and electron microscopy. The neurologic scores were 0 for all the rats in the control group and 2–3 for those in the MCAO group, suggesting that rat models were established successfully. The serum ghrelin level was higher in the MCAO group when compared with the control group (P < 0.05). However, the impelling force in MCAO rats was significantly lower than that of the control group (P < 0.05), reaching the lowest level at 24 hr. Damage to the intestinal mucosa, including villus intestinalis, vacuolar degeneration of organelles, widened cell–cell junctions, and apoptotic cells could be found under the light and electron microscopy. Our results showed that higher level of serum ghrelin decreased gastrointestinal motility and damage to the intestinal mucosa existed in rats with MCAO. Anat Rec, 2012. © 2011 Wiley Periodicals, Inc.