Background Although stroke unit care with early rehabilitation is recommended for most stroke patients, the content of the treatment given to acute stroke patients differs a lot. Aim The primary aim of this study was to describe the activity patterns of acute stroke patients managed in a stroke unit focused on early rehabilitation. Methods Patients admitted to the stroke unit at St. Olavs Hospital, Trondheim, with the diagnosis of stroke were asked to participate. Patients were eligible if they were less than 14 days post stroke and did not receive palliative care. Patients were observed every 10 mins from 8:00 am to 5:00 pm, and activity, location, and who helped them were recorded. Results A total of 117 patients (mean age 78·7 years; 56% male) were included. In total, patients spent 30·3% of time in bed, 46·4% of time in sitting out of bed, and 19·9% of time in higher motor activities such as transferring, standing, walking, or climbing stairs. Patients with mild, moderate, and severe stroke spent 79·5%, 59·2%, and 31·0% of observed time sitting out of bed or engaged in higher motor activities, respectively. Conclusion This study shows that it is possible for acute stroke patients to spend most of the active day out of bed and to engage in higher motor activities up to 20% of the time. It also shows that it is feasible for severely affected stroke patients to stay out of bed in the early phase after stroke.