Stroke is the leading cause of death in China and confers a huge burden and effort on patients and health professionals. China has the world's largest population and has been experiencing a rapid economic development. In this article, we review the current status of stroke epidemiological features and risk factors, and the recently ongoing stroke epidemiological survey in China. Epidemiological studies suggested that stroke incidence increases with age and that the elderly population is expected to increase over time in China. Stroke mortality increased gradually from 1990 to 2000 but declined since the beginning of the 21st century, probably related to better control of vascular risk factors and the advances in acute stroke care. The Chinese lifestyle has changed rapidly during the past 3 decades. Moreover, China is a big country with substantial geographic disparities. The geographical variation and chronological trend of vascular risk factors may determine changes in the prevalence and subtypes of stroke in China. In this review, the current Chinese researches on the critical management of stroke and the potential direction and support of the Chinese government are discussed.