The case fatality rate from one of the large hospital-based stroke registry was 7.2% within 30 days after the onset of acute ischemic stroke, which is similar to those of other series from western countries with an advanced medical care systems. It may be attributed to the inclusion of more asymptomatic or milder patients with small lesions detected by neuroimaging. Importantly, the delay of hospital visit after the onset of stroke and the lower compliance for secondary prevention remain serious problems in managing acute stroke in Korea. Despite recent advances in the diagnosis and management of stroke, there has not been a nationwide population-based epidemiologic data on stroke in Korea. Therefore the application of Internet technology to develop multi center cooperative hospital-based registry could be an important step toward a long-waited nationwide stroke registry.