OBJECTIVES: Atrial fibrillation (AF) increases the risk of stroke 5-fold and may be responsible for larger and more disabling strokes than those without AF which increase the associated costs of care. The purpose of this study was to evaluate direct and indirect costs of patients with AF-related stroke in China, producing an average cost per patient per year and the economic burden of the whole AF-related stroke Chinese population. METHODS: A cost-of-illness analyses was performed. Prevalence data on AF-related stroke for the Chinese population was collected from literatures. An observational retrospective study was conducted to collect the economic data. We recruited 156 patients diagnosed with AF and stroke in Beijing, Shanghai and Guangzhou between October 2012 and December 2012. Patients or their carers were interviewed about resource utilization and absenteeism from work in the past year. Direct medical costs included outpatient visit, hospitalization, ambulatory, drug, diagnostic tests, and physiotherapy costs. Indirect costs were estimated using a human capital approach. All costs referred to 2011. RESULTS: Among 156 patients with AF-related stroke, 59.35% were male and the mean age was 67.9±30.2 years. 98.0% patients have at least one kind of health insurance. From the societal perspective, total costs per patient over 1 year amounted to Chinese Yuan (CNY) 25538 (median: CNY13342, IQR: CNY7662-CNY 38714), with direct costs accounting for 94.2% and indirect costs for 5.8% of the total. And for the direct costs, the informal care costs were CNY9162. The drug costs were CNY6293. Based on the prevalence of AF and AF-related stroke in China from literatures, there was about 0.968 million patients of AF-related stroke. Costs for the nation are estimated at CNY24.7 billion per year. CONCLUSIONS: The economic burden of AF-related stroke in China is considerable. The primary burden on patients was due to informal care and drugs.