OBJECTIVES: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neurostimulation technique that uses magnetic field to comprehensively influence events in the brain. Its use in patients after stroke focuses mainly on influencing brain neuroplasticity and therefore has the potential to improve motor functions in these patients. This study investigates the effect of rTMS on motor function recovery in patients in the acute stage of ischemic stroke. DESIGN: This study was designed as a randomized double-blind placebo-controlled trial. MATERIALS AND METHODS: A total of 26 patients with motor impairment in the acute stage of ischemic stroke were enrolled. Participants were randomly assigned to receive 5 sessions of 10 Hz ipsilesional rTMS or placebo rTMS, in addition to standard pharmacotherapy and rehabilitation. Clinical evaluations of motor impairment and activity were performed, along with electrophysiological parameters of motor evoked potential (MEP), at baseline (1 -6 days after stroke) and after the completion of the 5 rTMS sessions (10 -14 days after stroke). RESULTS: The 10 Hz rTMS group demonstrated significantly greater improvements in most clinical motor function assessments compared to the placebo group. However, no significant changes in the electrophysiological parameters of MEPs were observed. CONCLUSION: The application of 10 Hz rTMS to the ipsilesional hemisphere shows promise in improving motor functions in patients in the acute stage of ischemic stroke. Although the results suggest potential therapeutic benefit, more research with larger sample sizes and comprehensive outcome measures is required to optimize rTMS protocols and fully understand its effects on motor recovery.