Background: Stroke now ranks as the second cause of death and the most common life threatening neurological disease. The best approach to reducing the burden of stroke remains prevention. Objectives: to determine the distribution of stroke in Upper Egypt by type, stroke risk factors , and to compare the results of the study with other national & international studies. Methods: prospective hospital-based study carried out in Neurology department of Sohag University hospital, involved 467 stroke patients. patients were subjected to history taking, examination and investigation. Demographic data, stroke-subtypes, stroke-prone individual, risk factors, and stroke outcome, were analyzed and compared with other multi-center, national and international studies. Results: hemorrhagic strokes reported in37.5%. 56.3% were above 60 years and 8.6% were below 40 years. 62% of stroke occurred in autumn-winter. Hemorrhagic stroke was higher in spring-summer. (53%). Stroke reported more in rural areas 57% .Non educated stroke patients were the commonest 67.5%, hypertension reported in 42% of patients, more in males 59%, especially in those>40years(97.4%), smoking in 37.7%, ischemic heart diseases in 32.8%, dyslipidaemia in 29.5%, history of TIA in 23.1% of, Diabetes in 21.6% of, Past history of similar stroke in 10.5%, obesity in 10.1%, Positive family history of stroke in 9.6%, atrial fibrillation in 6%, 60%. Rheumatic heart diseases reported in 5.6% of patients. Alcohol abuse reported in only 1.3% 66%. Conclusion: In Upper Egypt, we reported a higher incidence of Hemorrhagic stroke .Lower incidences of, hypertension, D.M., hyperlipidemia, previous attacks and alcohol consumption compared with other studies, higher rates of Rh.H.D. were reported compared with other international studies. (Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(1): 255-269). INTRODUCTION Stroke now ranks as the second leading cause of death and the first cause of morbidity allover the world. Among all the neurological diseases of adult life, stroke clearly ranks first in frequency and importance, at least 50% of the neurological disorders in a hospitalized patients are of this type1,2,3. The burden of stroke was estimated by the American Heart Association to be 51 billion dollars direct and indirect costs in 19994,5,6. Despite advances in medical care of stroke and the advent of treatment of selected patients with acute ischemic stroke, prevention remains the best approach to reduce the burden of stroke High –risk or stroke-prone individuals can be identified and targeted for specific interventions7. This is important because epidemiological data suggest a substantial leveling off prior declines in strokerelated mortality and a possible increase in stroke incidence8,9. The prevalence of stroke is heterogeneous and is greater among the elderly and men and is variable from one region to others10. Our aim was to study the pattern of stroke in upper Egyptian patients as regards the relative prevalence of different stroke-subtypes, the demographic data , and the prevalence of common stroke- risk factors. The study consisted of stroke patients admitted to Neurology Department o