In this study, Neural Networks (NN) modelling has emerged as a promising tool for predicting outcomes in patients with Brain Stroke (BS) by identifying key risk factors. In this longitudinal study, we enrolled 332 patients form Imam hospital in Ardabil, Iran, with mean age: 77.4 (SD 10.4) years, and 50.6% were male. Diagnosis of BS was confirmed using both computerized tomography scan and magnetic resonance imaging, and risk factor and outcome data were collected from the hospital's BS registry, and by telephone follow-up over a period of 10 years, respectively. Using a multilayer perceptron NN approach, we analysed the impact of various risk factors on time to mortality and mortality from BS. A total of 100 NN classification algorithm were trained utilizing STATISTICA 13 software, and the optimal model was selected for further analysis based on their diagnostic performance. We also calculated Kaplan-Meier survival probabilities and conducted Log-rank tests. The five selected NN models exhibited impressive accuracy ranges of 81-85%. However, the optimal model stood out for its superior diagnostic indices. Mortality rate in the training and the validation data set was 7.9 (95% CI 5.7-11.0) per 1000 and 8.2 (7.1-9.6) per 1000, respectively (P = 0.925). The optimal model highlighted significant risk factors for BS mortality, including smoking, lower education, advanced age, lack of physical activity, a history of diabetes, all carrying substantial importance weights. Our study provides compelling evidence that the NN approach is highly effective in predicting mortality in patients with BS based on key risk factors, and has the potential to significantly enhance the accuracy of prediction. Moreover, our findings could inform more effective prevention strategies for BS, ultimately leading to better patient outcomes.