Objective To explore the relationships between social support, positive coping, caregiver burden and family resilience of primary caregivers of first-stroke patients. Methods A questionnaire survey was conducted among 307 primary caregivers of first-stroke patients in 2 tertiary hospitals in Shanghai by convenience sampling method. Social support rating scale, simplified coping style questionnaire, Zarit caregiver burden interview, and family resilience assessment scale were used for questionnaire survey. Pearson correlation analysis and structural equation models were used for data analysis. Results A total of 288 valid questionnaires were collected, and the effective recovery rate was 93.81%. Pearson correlation analysis showed that there was a positive correlation between family resilience and social support, family resilience and positive coping, and social support and positive coping (r＝0.375, 0.627, and 0.277; all P＜0.01), while caregiver burden and social support, caregiver burden and positive coping, and family resilience and caregiver burden were all negatively correlated (r＝－0.203, －0.343, and －0.444; all P＜0.01). The mediating effect model was constructed with positive coping and caregiver burden as mediating variables, social support as independent variables, and family resilience as dependent variables. The results showed that social support could mediate family resilience through positive coping, with a mediating effect of 0.164, accounting for 26.1% of the total effect; social support could also affect the family resilience of the primary caregivers of first-stroke patients through the partial chain mediating effect of positive coping and caregiver burden, with a mediating effect value of 0.032, accounting for 5.1% of the total effect. Conclusion Social support can predict family resilience among primary caregivers of first-stroke patients, and positive coping and caregiver burden play chain mediating roles in the impact of social support on family resilience.