Defining prognosis may be helpful in planning acute treatment of stroke, setting rehabilitation goals and setting resource priorities. Case fatality is 12% within the first seven days of a first-ever stroke. Late deaths are usually due to the consequences of immobilisation and stroke recurrence. Long-term outcome is difficult to predict but older age, significant pre-stroke co-morbidity and severe stroke are generally associated with poor physical recovery. Stroke patients have a risk of recurrence 15 times that of an age- and sex-matched population. Stroke type may influence recurrence. Early stroke recurrence may be prevented by antiplatelet drugs. Patients in atrial fibrillation and with recently symptomatic high-grade carotid stenosis are at particular risk of stroke.