Subarachnoid hemorrhage and cerebral hemorrhage are the most frequent causes of sudden death due to stroke. Brainstem hemorrhage, which is the cause of respiratory and vasomotor centers dysfunction, is frequently the direct cause of sudden death caused by stroke, and not only cerebral edema, but also secondary lethal arrhythmia, myocardial infarction, pulmonary embolism, or asphyxiation by dysphagia may be indirect causes of death associated with stroke. To prevent sudden death due to stroke, management of respiratory and circulatory systems as well as treatment corresponding to the type or severity of the disease are required. In this issue, we discuss the cause, management, and prevention of sudden death due to stroke.