We studied the mortality from stroke as the underlying cause of death in Spain during the period 1901-1986. The age-adjusted mortality in 1986 was 114.4 per 100,000 among males and 100.6 per 100,000 for females. From 1901 to 1986, the SMR from stroke in Spain decreased by approximately 2/3, levelling off during the period 1950-1970, and again falling from 1973 on. A new plateau might have been initiated in the early 1980s. Since 1950, a marked continuous decrease is seen for hemorrhagic stroke and, since 1973, for ischemic stroke. In spite of difficulties in interpreting death record data, this study confirms that stroke mortality in Spain ranks on a medium level when compared with data from other European countries and that it conforms to the patterns reported for industrial countries. The drop in stroke mortality since 1973 preceded the widespread use of antihypertensive drugs.