OBJECTIVES: We examined the demographic change of stroke hospitalizations (by age, gender, and race) in Missouri from 2000-2012 using a nationally-recognized surveillance data system managed by the Missouri Department of Health and Senior Services. METHODS: The dataset includes counts of inpatient hospitalizations from stroke/cerebrovascular disease from 2000-2012. Changes in age, gender, and race were calculated over time; ethnicity and pay source were not investigated. Hospitalization rates were calculated for 45-64 and 65+ age groups and both genders. Due to geographic distribution of minority population in Missouri, the analysis of change in stroke rates by race gender group in the 65+ age group (i.e. White male, Black male, White female, Black female) was limited to the 20 largest counties in Missouri, which account for about 70% of state’s total population. Race-gender group differences were expressed as White minus Black. RESULTS: Statewide stroke hospitalization rates decreased by 27.8% from 2000-2012 in the 65+ age group, while rates remained largely unchanged over the same period for the 45-64 age group. The rates fell 30.5% and 24.3% for female and male groups, respectively. When comparing White males vs. Black males, the White males had much higher (79%) stroke hospitalization rates than Black males in 2000-2002, but the difference approached zero over time. A similar trend was observed for White females vs. Black females. CONCLUSIONS: Prior research has shown that stroke rates declined in people aged ≥ 60 years but remained unchanged in the 45-59 age group from 2000-2010; our results concur with this finding. Furthermore, our results on race variation agree with another research study that explained the decline in stroke prevalence for the White cohort but not the Black cohort. But, male and female inpatient hospitalizations were fairly similar, which doesn't coincide with national findings that women have a higher lifetime risk of stroke than men.