OBJECTIVES: To determinate the co-morbidity and direct costs of stroke among Spanish population in daily medical practice. METHODS: A retrospective study was performed based on data from patients attended for stroke, aged>30 years, from five Spanish primary care centres (PCC) and two hospitals in 2006. Main analysed variables were: age, sex, general or specific (cardiovascular and others) events/co-morbidities, use of drugs, clinical parameters (according to NCEP-ATPIII) and direct costs (pharmacy, derivations, visits, emergencies, procurement, and hospitalisation). An ANCOVA analysis and logistic regression were used to fit the model. RESULTS: Of 57.026 patients included in the analysis, 4.5% (n=2.585, CI95%: 4.3-4.7%) suffered stroke. The incidence of stroke was 220 new cases/100.000 populations. Main differences between patients suffering stroke and control group were: age (72.5 vs. 53.5), men (58.2% vs. 44.6%), events/year (7.9 vs. 4.8), visits/year (15.8 vs. 8.1), poli-pharmacy (91.5% vs. 53.6%), use of statins  (85.0% vs. 32.2%), antiagregants and/or anticoagulants (78.9% vs. 28.0%), p<0.001 for all differences. Stroke had an independent relation with age (odds ratio, [OR]=1.4), male gender (OR=2.3), diabetes (OR=1.6), hypertension (OR=1.5), smoking (OR=1.5), alcohol abuse (OR=1.4), depression (OR=1.4), dyslipidemia (OR=1.3) and dementia (OR=1.2). Some of the results were: systolic pressure (134.1 vs. 127.6 mmHg), body mass index (28.9 vs. 27.9 kg/m2) and LDL-cholesterol (116.4 vs. 126.2 mg/dl), in presence/absence of stroke, p<0.001. The average of annual costs of stroke was €2590.36 vs. €985.26, p<0.001. After the correction of the logistic model results did not change: €1774.33 (IC: 1720.10-€1.828.55) vs. €1021.98 (IC: 1010.92-€1033.03€, p<0,001. All components of costs were higher in the stroke group. CONCLUSIONS: Prevalence and incidence are similar to that published in the literature. Patients that demanded assistance for stroke had a higher number of co-morbidities and a higher total cost/patient/year. Therapeutic objectives could be improved, mainly in primary prevention of cardiovascular risk factors.