Objective: We sought to assess the current status of blood pressure control and the use of antihypertensive drugs in patients with ischemic stroke (IS) or transient ischemic attack (TIA) in China. Subjects and methods: A cross-sectional study (across 19 urban outpatient clinics) on secondary stroke prevention measures was conducted. All subjects diagnosed with IS or TIA at neurological clinics were enrolled consecutively. Face to face interviews were conducted by a trained neurologist and research assistant using questionnaire at the same day of enrollment. Results: A total of 2283 IS or TIA patients were included in the survey. A history of hypertension was present in 1509 patients, of which 896 (59.4%) had uncontrolled blood pressure. A history of hypertension was absent in 603 patients, of whom 162 (26.9%) had uncontrolled blood pressure. In addition, 495 (88.9%) of patients with diabetes mellitus had uncontrolled blood pressure (systolic blood pressure >= 130 mmHg or diastolic blood pressure >= 80 mmHg). In multivariate logistic regression analysis, having monthly income of >1000 yuan [odds ratio (OR): 2.040; 95% confidence interval (CI): 1.277-3.259), female (OR: 1.546; 95% CI: 1.174-2.034) and smoking habits (OR: 1.428; 95% CI: 1.014-2.013) remained significantly associated with blood pressure control. In contrast, compound preparation (OR: 0.685; 95% CI: 0.473-0.993) was inversely associated with the likelihood of blood pressure control. Conclusion: Blood pressure control rate among IS or TIA patients in major metropolitan clinics is an important issue in China which might largely influence the efforts in stroke prevention and treatment. Further works are needed to develop substantive quality improvement strategies of stroke secondary prevention care.