Background <p>Self-management significantly affects the physical and mental recovery of elderly stroke patients and can improve their quality of life. This study aims to describe the current status and investigate the correlations of e-health literacy, self-management abilities, and perceived social support among elderly stroke patients. Furthermore, it explores the mediating effect of perceived social support on the relationship between e-health literacy and self-management abilities in elderly stroke patients.</p> Methods <p>337 elderly stroke patients from four tertiary hospitals in Hunan Province were recruited via convenience sampling and completed a demographic questionnaire, the eHealth Literacy Scale, the Perceived Social Support Scale, and the Stroke Self-Management Ability Scale, between March and May 2024. Statistical analyses were conducted using independent samples t-test, one-way analysis of variance, Pearson correlation analysis, and the Bootstrap method.</p> Results <p>The total scores for eHealth literacy, self-management ability, and perceived social support among elderly stroke patients were 17.43 ± 8.11, 87.76 ± 13.39, and 55.33 ± 12.09, respectively. The three variables were positively correlated (<i>P</i> &lt; 0.05), and perceived social support partially mediated the relationship between eHealth literacy and self-management ability in elderly stroke patients, accounting for 49.02% of the total effect.</p> Conclusions <p>In elderly stroke patients, e-health literacy is low, self-management ability is medium, and perceived social support serves as a partial mediator between them. It was suggested that medical staff focus on the social support system of elderly stroke patients, increase their use of social support, and then improve their e-health literacy for the purpose to provide a solid foundation for promoting their self-management of the disease and enhancing their quality of life.</p>