OBJECTIVES: Stroke is the second leading cause of death in China, and its incidence is expected to increase over the years despite primary prevention efforts. The aim of this study was to compare the costs and health effects of stroke rehabilitation strategies in eastern China. METHODS: A literature review of the possible stroke rehabilitation strategies was conducted to compare their impact on costs and health effects. Treatment effects were based on changes measured using functionality scales such as the Modified Barthel Index (MBI). These changes were transformed into general health-related quality of life (QOL) improvement according to a generic QOL instrument (EQ-5D). Costs included direct medical and non-medical costs but did not include indirect costs. RESULTS: Three different strategies could be identified. The first strategy is one month of hospitalization including rehabilitation, which is what most stroke patients receive. The second is one month of hospitalization with rehabilitation for six months. The third strategy is hospitalization for six months and no active rehabilitation. Rehabilitation for six months achieves the greatest health improvement (MBI=65) but at the greatest cost (RMB34,000), while one month of hospital including rehabilitation is the least effective (MBI=35) and cheapest strategy (RMB19,000 RMB). Extended hospitalization without rehabilitation results in intermediate costs and effects (MBI=45 at a cost of RMB29,500). CONCLUSIONS: Full rehabilitation for six months appears to be the most cost effective option for stroke patients in China. Unfortunately, this strategy is out of reach for most Chinese patients, and this is due to many factors including lack of facilities and skilled personnel. Efforts need to be taken to find effective and cost-effective strategies that can be provided to the majority of Chinese stroke patients.