Abstract: Objective: To investigate the current status and influencing factors of pre hospital stroke symptoms and cope knowledge among residents in Harbin. Methods: Totally 574 residents with high risk for stroke and their caregivers in Harbin were recruited and investigated by Pre Hospital Stroke Symptoms Coping Test. Results: The mean score for the questionnaire was (59.45±16.16), which was in a moderate to inferior level. Three parts, cope of typical symptoms with convulsive, the typical symptoms, and typical symptoms with vomiting, had highest score according to the standardized scores, Multiple linear regression analysis showed that the influencing factors included bad living styles (smoking, drinking), educational background,medical examination, and stroke awareness (P<0.05). Conclusion: The pre hospital stroke symptom and management knowledge among residents in Harbin is in a moderate to inferior level, which was influenced by bad living styles (smoking, drinking),educational background, medical examination, and stroke awareness.