OBJECTIVES:  Objectives of this study were to examine the depression treatment patterns and predictors among stroke survivors with comorbid depression seeking care in ambulatory settings in the United States (US). METHODS: We used a cross-sectional study design by pooling multiple-year data (2005-2011) from the National Ambulatory Medical Care Survey and the outpatient department of the National Hospital Ambulatory Medical Care Survey. Older adults (age ≥ 50 years) with stroke and depression comprised the final study sample. Ambulatory visits that involved stroke diagnosis were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of 430.xx-438.xx. Depression was identified in visits where the answer to the question “Regardless of the diagnoses written…..does the patient now have: depression?” was “yes.” Depression treatment defined as antidepressant use with or without psychotherapy comprised the dependent variable in this study. Multivariate logistic regression analysis was conducted to ascertain the predictors of depression treatment. All analyses were adjusted for the complex survey design of the datasets to obtain nationally representative estimates. RESULTS:  During 2005-2011 timeframe, approximately 3.96 million ambulatory care visits recorded a stroke and depression diagnosis. Overall depression treatment was observed in 47.32% of the study sample, mainly driven by antidepressant use alone. An overwhelming majority used selective serotonin reuptake inhibitors (77% of overall antidepressant use), and sertraline was the most prescribed antidepressant (30.5% of overall antidepressant use). Sex, race/ethnicity, region of residence, number of medications recorded at the sampled visit, and number of chronic conditions were significantly associated with depression treatment. For example, men were approximately three-times more likely (Odds Ratio=2.772; 95% CI, 1.127-6.819, P=0.027) than women to receive depression treatment. CONCLUSIONS: According to this nationally representative sample, depression treatment is low among stroke survivors in ambulatory care settings in the US. Appropriate interventions should be developed to optimize post-stroke depression treatment.