Each year, an estimated 795,000 adults in the United States have a stroke, making it the fifth leading cause of death and the tenth leading cause of adult disability. Current literature addresses the use of osteopathic manipulative treatment (OMT) for pain and physical limitations in the post-acute outpatient setting. However, stroke patients can benefit additionally from rehabilitation in the subacute hospital setting as demonstrated by this case study. A 53-year-old Caucasian female presented to the emergency department with a history of slurred speech and right-sided weakness secondary to a left middle cerebral artery (MCA) stroke. Head computed tomography angiogram (CTA) demonstrated moderate stenosis of the distal M1 segment of the left MCA. The inpatient osteopathic manipulative medicine team was consulted on day three of admission for total body pain related to positional changes, muscle contractures and chronic rheumatoid arthritis. Following six sessions of osteopathic manipulative treatment (OMT), the patient reported improvement of pain in all treated regions as well as increased motor function in the paralyzed right side. Over the course of treatment, the patient experienced decreased need for assistance with activities of daily living and ambulation. OMT was performed in both the neurological intensive care unit and the inpatient rehab facility for a total of fourteen treatments over thirty-six days. Treatment included indirect techniques for diagnosed somatic dysfunctions and surrounding structures and improved physical restrictions bilaterally. This case demonstrates that in conjunction with evidence-based physical and occupational therapies, subacute stroke OMT increases biomechanical functionality as demonstrated by the increased functionality of both the paralyzed extremities and the newly dominant side.