Stroke prevention and treatment in China have achieved significant progress in reducing the disease burden and controlling major risk factors. However, important challenges remain, including a growing number of stroke cases and the need to establish a comprehensive and efficient patient management system spanning the pre-hospital, in-hospital, and post-hospital phases. This article systematically reviews the current status and key issues in stroke prevention and control and proposes that greater emphasis should be placed on accelerating the transition from a “treatment-oriented” to a “prevention-oriented” approach in stroke management. It highlights the importance of building a full lifecycle health-care system for stroke prevention and care, enhancing the effectiveness of interventions through a tiered and coordinated care model, and promoting the deep integration of digital and intelligent technologies. These efforts may provide valuable guidance for clinical practice and support the achievement of the “Healthy China” goals.