We set out to discover how satisfied patients and carers were with existing stroke services. We prospectively identified 164 consecutive patients admitted to a department of general medicine with acute stroke and collected data using a satisfaction questionnaire in a semi-structured interview. of the 110 (67%) survivors, 65 (59%) patients and 80 (73%) carers completed an interview. We also interviewed 34 bereaved carers. Most patients (97%), carers (92%) and bereaved carers (94%) were satisfied with care overall. However, 30 (46%) of our patients, 53 (66%) carers and 18 (53%) bereaved carers who were satisfied with care overall expressed dissatisfaction with at least one component. Carers of patients were significantly more dissatisfied than the patients themselves with the amount of information given and with social work intervention. Carers of patients who were unable to respond to the questionnaire themselves, usually because of cognitive difficulties, were the most dissatisfied group even when compared with bereaved carers. Measuring satisfaction can alert one to deficiencies within a service, aiding service development, but interpreting patients' and carers' overall satisfaction. Efforts to improve communication, discharge planning and follow-up, aimed at carers as well as the patients themselves, are likely to be rewarded with improved satisfaction with stroke services.