With 6.5 Mio deaths in 2019, cerebrovascular disease is the second most frequent cardiovascular cause of death worldwide and a major cause of long-term disability. Of all strokes, 87% are ischemic and are most often due to atherosclerosis of extra- and intracranial vessels or embolism. Hemorrhagic stroke is another important mechanism with a particular high rate of mortality and disability. Stroke incidence as well as stroke mortality differ widely in Europe with the highest values reported from Eastern European countries. Age, sex, ethnicity, and socioeconomic differences are other important epidemiologic factors.