Background <p>Stroke is a leading cerebrovascular disease characterized by high incidence and significant disability rates. Following the acute phase, most stroke survivors require prolonged home-based rehabilitation and care, a responsibility predominantly undertaken by primary family caregivers. The sustained demands of caregiving often impose considerable physical, psychological, and social burdens on these individuals.</p> Objective <p>This review aims to systematically identify and synthesize the factors influencing the caregiving burden among primary family caregivers of stroke survivors.</p> Methods <p>This scoping review followed the Joanna Briggs Institute’s methodological framework. A comprehensive literature search was conducted in the following databases: Web of Science, PubMed, CINAHL, Cochrane Library, Embase, CNKI, CBM, Wanfang Date, and VIP. The search included articles published from inception until October 24, 2025. All study designs reporting on factors influencing the caregiving burden of primary family caregivers of stroke survivors were eligible for inclusion.</p> Results <p>A total of 2005 records were identified, of which 35 articles met the inclusion criteria. The included studies comprised 30 cross-sectional studies (85.71%), four prospective cohort studies (11.43%), and one mixed-methods study (2.86%). Most of the included studies were from Asian countries, including China (<i>n</i> = 28), South Korea (<i>n</i> = 2), Poland (<i>n</i> = 2), Greece (<i>n</i> = 1), India (<i>n</i> = 1), and Thailand (<i>n</i> = 1). Eleven studies (31.4%) reported incidence data, but substantial heterogeneity precluded direct quantitative synthesis. A total of 65 influencing factors were identified and grouped into three categories: caregiver-related factors, patient-related factors, and family and social support factors. The most frequently reported factors included caregiver age (<i>n</i> = 19), average daily caregiving hours (<i>n</i> = 19), patient activities of daily living (<i>n</i> = 19), caregiver - patient relationship (<i>n</i> = 16), and caregiver education level (<i>n</i> = 16).</p> Conclusion <p>The caregiving burden among primary family caregivers of stroke survivors is influenced by a wide range of factors. To reconcile inconsistent or contradictory findings, further research using standardized assessment tools and methodologies is warranted.</p>