This meta-analysis examines the relationship between cigarette smoking and stroke, addressing the lack of consensus in previous studies. The analysis includes 32 separate studies, with a pooled relative risk of 1.5 (95% confidence interval 1.4 to 1.6) for all strokes. Significant differences were observed among subtypes: cerebral infarction (1.9), cerebral hemorrhage (0.7), and subarachnoid hemorrhage (2.9). Age also influenced the relative risk, with younger individuals having a higher risk. A dose-response relationship was noted between the number of cigarettes smoked and the relative risk, and women had a slightly higher risk compared to men. Ex-smokers under 75 years old retained a notable increased risk of stroke. The meta-analysis provides strong evidence that cigarette smoking is a risk factor for stroke, suggesting it should be added to the list of diseases associated with smoking.This meta-analysis examines the relationship between cigarette smoking and stroke, addressing the lack of consensus in previous studies. The analysis includes 32 separate studies, with a pooled relative risk of 1.5 (95% confidence interval 1.4 to 1.6) for all strokes. Significant differences were observed among subtypes: cerebral infarction (1.9), cerebral hemorrhage (0.7), and subarachnoid hemorrhage (2.9). Age also influenced the relative risk, with younger individuals having a higher risk. A dose-response relationship was noted between the number of cigarettes smoked and the relative risk, and women had a slightly higher risk compared to men. Ex-smokers under 75 years old retained a notable increased risk of stroke. The meta-analysis provides strong evidence that cigarette smoking is a risk factor for stroke, suggesting it should be added to the list of diseases associated with smoking.