In Canada in 1991, about 15,000 persons died from cerebrovascular disease, a figure that represented 7% of all deaths. Currently, cerebrovascular disease accounts for over 67,000 hospital discharges and 3.2 million days of hospitalizations per year. This paper examines the declining trends in stroke mortality from 1951 to 1991, by age and sex. Comparisons of mortality rates by income quintiles and cohort effects are discussed. By comparison with other countries, Canada has one of the lowest rates of death from cerebro-vascular disease. With an aging population, the burden of stroke measured in terms of death, disability and health care costs, remains a major challenge for preventive and health care policy.