OBJECTIVE: to assess the economic and epidemiologic impact of stoke in Friuli Venezia Giulia (FVG) a region of approximately 1.2 million inhabitants in the north-eastern Italy. METHODS: All residents of FVG are registered in to Regional Health Service (RHS) database, which keeps tracks of the use of medical care admissions and reimbursement purposes. We selected residents of FVG who had during year 2000 a first stoke hospital admission and we followed them up till death, or December 31, 2004. (we a priory excluded people who during the period 1995-1999 had a previous CVD event). Mortality was investigated by collecting information from Regional Citizen Register file. We obtained information on medical costs from electronic databases of prescriptions, hospitalizations, visits and diagnostic examinations in FVG. Direct medical costs were quantified in the perspective of the RHS and are expressed in Euro 2005. RESULTS: We enrolled 936 patients with incident stroke (mean age 77 ± 12 y.o.), 55.4% were women. The average cost person/year was euro 3502,87; 73.9% attributable to hospitalisations, 17.5% to drugs, 8,6% to other medical costs. The 32.8% patients died during the follow up period, with a mean age of 84 ± 9 statistically different (p<0.0001 ) from survivors (mean age 74 ± 11 y.o.). CONCLUSIONS: Stroke imposes a large social and economic burden on NHS and society because of the large number of hospitalisation and the high rate of mortality. Future investigations will be conduct to asses the relationships between comorbidity, costs, drug therapy and survival.