This review summarizes the sex differences in stroke, focusing on epidemiology, clinical presentation, medical care, and outcomes. Stroke has a greater impact on women due to their longer life expectancy and higher incidence at older ages, leading to more stroke events than men. Although there is little evidence of sex differences in stroke subtype or severity, women are less likely to receive certain in-hospital interventions, such as thrombolytic treatment and lipid testing. Functional outcomes and quality of life after stroke are consistently poorer in women, even after adjusting for baseline differences in age, prestroke function, and comorbidities. Women have higher rates of hypertension, atrial fibrillation, and prestroke disability, but lower rates of heart disease, peripheral vascular disease, and smoking and alcohol use. Women are less likely to receive intravenous alteplase treatment and lipid testing while in hospital, and after stroke, they have poorer functional outcomes, more depression, and lower quality of life than men. Women are also more likely to live alone and be socially isolated, which may contribute to poorer outcomes. Sex differences in stroke care are influenced by biological factors, such as sex steroid hormones, and social factors, such as living arrangements and social support. Women are less likely to receive certain diagnostic and treatment procedures, such as brain imaging, carotid ultrasound, and echocardiograms. Women also have lower use of antiplatelet medications, warfarin, and statins. However, women who receive these treatments seem to benefit similarly to men. Women are less likely to be discharged home and more likely to be discharged to nursing homes and long-term care after a stroke. They also have lower physical function scores and are more likely to experience depression and lower quality of life. The causes of these differences are not fully understood, but they may be related to differences in age, prestroke function, comorbidities, and social support. Future research should focus on understanding the biological and social factors that contribute to sex differences in stroke outcomes and developing sex-specific interventions to improve recovery and reduce the burden of disability in women.This review summarizes the sex differences in stroke, focusing on epidemiology, clinical presentation, medical care, and outcomes. Stroke has a greater impact on women due to their longer life expectancy and higher incidence at older ages, leading to more stroke events than men. Although there is little evidence of sex differences in stroke subtype or severity, women are less likely to receive certain in-hospital interventions, such as thrombolytic treatment and lipid testing. Functional outcomes and quality of life after stroke are consistently poorer in women, even after adjusting for baseline differences in age, prestroke function, and comorbidities. Women have higher rates of hypertension, atrial fibrillation, and prestroke disability, but lower rates of heart disease, peripheral vascular disease, and smoking and alcohol use. Women are less likely to receive intravenous alteplase treatment and lipid testing while in hospital, and after stroke, they have poorer functional outcomes, more depression, and lower quality of life than men. Women are also more likely to live alone and be socially isolated, which may contribute to poorer outcomes. Sex differences in stroke care are influenced by biological factors, such as sex steroid hormones, and social factors, such as living arrangements and social support. Women are less likely to receive certain diagnostic and treatment procedures, such as brain imaging, carotid ultrasound, and echocardiograms. Women also have lower use of antiplatelet medications, warfarin, and statins. However, women who receive these treatments seem to benefit similarly to men. Women are less likely to be discharged home and more likely to be discharged to nursing homes and long-term care after a stroke. They also have lower physical function scores and are more likely to experience depression and lower quality of life. The causes of these differences are not fully understood, but they may be related to differences in age, prestroke function, comorbidities, and social support. Future research should focus on understanding the biological and social factors that contribute to sex differences in stroke outcomes and developing sex-specific interventions to improve recovery and reduce the burden of disability in women.