Mortality data are one of important indicators for the publich health The aim of this study is to know about the death rate, characteristics and risk factors of stroke as underlying cause of death in Padang Pariaman district. The mortality data in 2010 was analyzed using SPSS 16. The results showed that the entire death data was amount of 2642 and crude death rate was 6.71. Proportion of stroke in the district was 19.3% and stroke mortality rate was 1.29 per 1000 population in the year 2010, The risk factors of stroke as underlying cause of death after adjusted with education, employment and place of death were age and gender. The age of 40 – 64 years had the risk with OR of 6.45 (95% CI 2.77 – 14.28, p < 0.0001) and age of > 65 years had the risk of 10.29 (95% CI 4.47 – 23.69, p < 0.0001) compared to 20 – 39 year old. Women had greater risk than that of men with OR of 1.43 (95% CI 1.16 – 1.76, p < 0.001). The mortality rate of stroke as an underlying cause of death is high, so it is necessary to prevent the disease by appropriate intervention program.