Stroke is one of the leading causes of death and disability worldwide, accounting for almost 10% of all global mortality. While global stroke incidence has declined in high-income countries (HICs) due to advances in healthcare, the burden is shifting towards low- and middle-income countries (LMICs), where stroke incidence and related mortality are on the rise. Stroke risk factors are a complex mix of non-modifiable and modifiable elements. The aging population and increasing prevalence of conditions like atrial fibrillation and malignancy-associated hypercoagulability are contributing to a higher stroke burden. Emerging trends also show a rise in stroke incidence among younger populations, particularly due to higher rates of obesity, hypertension, and substance abuse. Environmental factors, including air pollution and the COVID-19 pandemic, are further exacerbating the global stroke burden. Key advancements in stroke care, such as thrombolytic therapies and endovascular thrombectomy, have improved outcomes in HICs, while disparities remain in LMICs. This chapter provides an in-depth overview of stroke epidemiology, risk factors, and trends, emphasizing the need for a multifaceted approach to prevention, management, and policy.