OBJECTIVES: The purpose of this study is to determine the annual economic burden of stroke, given that cerebrovascular disease is one of the leading causes of death and disability in Greece. METHODS: Retrospective database selection was made regarding patients with stroke, hospitalized in Greek hospitals. We modeled the disease based on the existing epidemiological, demographic, clinical and economic data in order to estimate direct and indirect cost by stroke type, degree of severity, age group and deaths. Clinical data derive from National Statistical Service of Greece. Incidence and prevalence data are based on Greek experts´ published reports. Impatient care unit costs, sickness funds payments, patients´ out- of- pocket money and any other expenses are based on prices set by the Ministry of Labour. Cost analysis is based on one-year patients´ treatment and survival. RESULTS: Annual direct cost per patient is $6,700 including hospital - pharmaceutical care, laboratory - diagnostic tests, outpatients’ visits and rehabilitation. Percentage distribution is 45% hospital care, 30% rehabilitation, 10% diagnostic tests, 9% pharmaceutical care and 6% consultation. The annual burden to the sickness funds is estimated at $7,000 per severe event and $2,000 per moderate event. Losses from the societal perspective are estimated at $25,700 for the severe and $6,300 for the moderate event. CONCLUSIONS: Annual direct cost of stroke is estimated at $170million in Greece. Sickness funds cost is $20,7 million while the societal burden is much higher at $58,3 million due to chronic residual disabilities. Given the considerable societal and economic impact of stroke in Greece, enormous clinical and economic benefits could be achieved through the expansion of secondary prevention, the adoption of economic evaluation analyses regarding the various interventions and drug therapies and finally through the creation of specialized stroke units, non-existent in our country.