© 2022 Somsak Tiamkao, Kamonwon Ienghong, Lap Woon Cheung, Ismet Celebi, Takaaki Suzuki, Korakot Apiratwarakul.BACKGROUND: Thrombolytic treatment is the main treatment of acute ischemic stroke. Thailand started thrombolytic treatment in 2008 only at university hospitals in Bangkok and gradually increased services in large provincial hospitals until widespread in 2014. However, no studies regard the services in stroke management in Thailand. AIM: This study aims to present data: Incidence, rate of thrombolytic treatment, and mortality rate of acute stroke in Thailand for 13 years METHODS: A study from the National Health Security Office’s database between 2009 and 2021 was reported using percentage statistics, and the number of patients per 100,000 population. RESULTS: The overall incidence of acute stroke patients aged 15 years and over was 172.33–328.00/100,000 population. The incidence of acute ischemic stroke patients aged 15 years and over was 90.37–222.73/100,000 population. The incidence of non-traumatic intracerebral hemorrhage patients aged 15 years and over was 55.77– 87.63/100,000 population. Rate of acute ischemic stroke patients who treated with thrombolytic treatment was 0.18– 8.04%. Mortality rate of acute stroke patients was 10.24–14.77%. Mortality rate of acute ischemic stroke patients who treated with thrombolytic treatment was 3.97–10.53%. CONCLUSIONS: Stroke incidence tends to increase over 13 years. Acute ischemic stroke patients receiving thrombolytic treatment tend to increase in number. The mortality rate in patients with acute stroke tends to decline. Especially in patients with acute ischemic stroke, the mortality rate was greatly reduced.