OBJECTIVES: The economic burden of stroke is approximately 3% of total healthcare costs or 0.3-1.8% of Gross National Product in developed countries.  Identifying what drives value and cost in post-stroke care can advance development of cost-effective interventions that improve long term outcomes.  This review characterizes costs associated with stroke rehabilitation METHODS: PUBMED was searched between 2000 and 2010; search terms included stroke, rehabilitation, costs, pharmacoeconomic and price. Countries of interest were Canada, China, France, Germany, Italy, Japan, Spain, UK, and US. Data were synthesized qualitatively. RESULTS: Of 941 abstracts, 28 met inclusion criteria.  Manual searching of retrieved papers and websites yielded 4 additional sources. The main factor determining cost was the country in which the study was conducted. Patients with severe stroke are routinely considered for rehabilitation; those with mild-moderate stroke (60–75% of stroke survivors) are typically discharged directly to home. Of all stroke patients, only 10-15% receive rehabilitation. Countries spending a large proportion on long term care for patients post-stroke, spent proportionally less on inpatient care.  Inpatient costs account for an average of 76% of costs in the first year following stroke. Rehabilitation costs are often included in inpatient costs, with the majority of rehabilitation costs occurring in year 1 (82% for patients with hemiparesis; 67% for patients without hemiparesis).  Evidence suggests that stroke unit care improves long term outcomes as compared to conventional treatment. There are few data on indirect costs despite the recognition that they are likely to be substantial. CONCLUSIONS: Cost studies in stroke are heterogeneous, lack specific economic data and rarely include long term rehabilitation cost of care. Future studies should aim to differentiate 1) direct costs of various rehabilitation services, 2) location for provision of rehabilitation services, and 3) indirect costs to demonstrate cost-effectiveness and value of rehabilitation on long term outcomes.