Objective: To assess trends in utilization of stroke-related outpatient physician services by physician specialty over the past 6 years. Methods: This study was a retrospective analysis of the National Ambulatory Medical Care Survey (NAMCS) from 2000¨C2005. Ischemic stroke related visits in persons aged =45 years were identified using diagnosis codes (ICD9CM) 433.1x, 434.xx, and 436.xx. Visits per/1000 persons were calculated using United States population estimates. With logistic regression, we adjusted associations between stroke-related visits and physician type (Neurology, Primary Care, and Cardiovascular Medicine), for age, race, and region (Northeast, Midwest, West, and South), sex, diabetes, hypertension, insurance type, and survey year. Results: From 2000 to 2005, stroke related outpatient physician office visits ambulatory care visits increased significantly from 4.7/1000 persons to 6.3/1000 (P Trend = <0.0001) persons, a 131% increase. During the study period, the proportion of ambulatory stroke-related visits that were to a neurologist increased significantly from 15.5% in 2000 to 26.3% in 2005 (P Trend = <0.0001). However, during the same period, visits to primary care (2000: 74.4% vs. 2005: 67.8%), and cardiovascular medicine (2000: 10.0% vs. 2005: 5.9%) decreased. After adjustment, greater odds of stroke-related visits to neurologist (OR = 10.6 95% CI: 7.9-14.1) whereas no significant differences were observed for cardiovascular medicine (OR = 1.5 95% CI: 0.9-2.2) (Reference Category: Primary Care). Conclusion: From 2000 to 2005, stroke-related ambulatory physician visits increased significantly overall but particularly to neurologists. Secondary stroke prevention, historically performed by primary care physicians in the US, may be increasingly performed by neurologists. Given predictions for large rises in stroke prevalence due to the aging population and improved stroke survival, US demand for neurologists may be insufficient.