Acute ischemic stroke may be the first clinical manifestation of the underlying cardioembolic source. We are reporting a 28-year-old man presenting with acute posterior circulation infarct due to underlying bicuspid aortic valve disease with vegetation detected by transesophageal echocardiography in the absence of clinical features of heart disease and infective endocarditis. The case report highlights the importance of routine evaluation of cardioembolic sources in all cases of ischemic stroke.