China is a country with the highest morbidity of stroke in the world. Although the Stroke Prevention and Control Project Committee of the National Health Commission has made great efforts in recent 10 years, the situation of stroke prevention and control is still grim. Poor national medical literacy, complex medical environment, unbalanced distribution of stroke centers and unbalanced stroke treatment levels in different hospitals often lead to the failure of timely hospitalization or diagnosis and treatment of stroke. Construction of regional stroke alliance is urgent and plays a significant role in exploring the hierarchical diagnosis and treatment of stroke, setting up emergency aid and transform mode, standardizing stroke work process, carrying out clinical practice and health education, and improving the stroke diagnosis and treatment levels of regional stroke centers at all levels, especially in grass-root hospitals. At present, different forms of regional stroke alliances have been established around the country, which not only give play to the advantages of stroke centers, but also improve the diagnosis and treatment of stroke, win the golden rescue time, and comply with the construction strategies of National Medical Association and specialty alliances. Although initial benefits have been achieved, there is still a long way to go. Further plan is needed to improve the regional stroke alliance and establish a regional efficient and intelligent "1-h golden treatment circle of stroke", so as to strive for the early "inflection point" of stroke prevention and treatment.