The aim of research is epidemiological characteristics in region of Kostroma and Yaroslavl from 2004 to 2006 years. 630 cases of stroke per 108 284 adult population in Kostroma and 542 cases of stroke per 123 977 adult population in Yaroslavl were registered. Data about stroke morbidity, mortality and death rate were compared. Stroke causes and risk factors were considered in dependence of social and economic development of cities and ecologic indexes. Conclusions on the possibilities of decreasing risk factors with the help of adequate prevention are made.