Control of hypertension is well established for the primary prevention of stroke. Prior studies, on the other hand, conflict over whether hypertension remains a risk factor for recurrent stroke and if blood pressure reduction is associated with better outcomes in this subset of patients. We review current evidence regarding the role of BP lowering for primary and secondary prevention of stroke. Current evidence amassed from both primary and secondary prevention trials demonstrate that BP reduction is a crucial common element in overall reduction of stroke risk.