Diet may influence stroke risk via several mechanisms, but the optimal dietary habits for stroke prevention are not well established. We reviewed English-language MEDLINE publications from January 1979 through November 2004 for experimental, observational, and clinical studies of dietary factors (minerals, fats, cholesterol, fish, animal protein, fiber, whole grains, carbohydrate quality, fruits and vegetables, antioxidants, B vitamins, dietary patterns) and risk of stroke or hypertension, the principal modifiable stroke risk factor. A total of 121 publications were selected based on relevance and quality of design and methods. Diets low in sodium and high in potassium lower blood pressure which will likely reduce stroke risk. Consumption of fruits and vegetables, whole grains, folate, and fatty fish are each likely to reduce stroke risk. A prudent or traditional Mediterranean dietary pattern, which incorporates these individual dietary components as well as intake of legumes and olive oil, may also prevent stroke. Evidence is limited or inconsistent regarding optimal levels of dietary magnesium, calcium, antioxidants, total fat, other fat subtypes, cholesterol, carbohydrate quality, or animal protein for stroke prevention. A diet low in sodium, high in potassium, and rich in fruits, vegetables, whole grains, cereal fiber, and fatty fish will likely reduce the incidence of stroke. Further research is needed regarding the possible effects of other major dietary factors on stroke risk.