Women have a higher prevalence of stroke at an older age compared to men. Atrial fibrillation (AF) and diabetes have a higher mortality and stroke risk in women than in men. Migraine with aura is twice to four times as common in women than in men and doubles the risk of stroke. A previous history of preeclampsia is an independent female-specific risk factor for stroke. The use of hormonal therapy (HT) in menopause also increases stroke risk. Women may have more speech difficulties at onset of stroke, which may delay hospital referral. This chapter updates our knowledge on sex- and gender differences in stroke.