Abstract: Objective: To explore the effect of the intensive follow-up transitional care management on young and middle aged patients with stroke. Methods: Totally 250 young and middle aged patients with stroke were randomly distributed into the control group (n=125) and the treatment group (n=125). The control group received regular telephone follow-up and outpatient follow-up after hospital discharge and the treatment group took intensive follow-up management.We compared the capacity in daily life, the incidence rate of end point and the care burden when the patients were discharged at 3months, 6months and one year respectively. Results: There was significantly difference between two groups at the level of capacity in daily life, care burden and incidence rate of end point (P<0.05). Conclusion: The intensive following-up transitional care management could increase the level of capacity in daily life but reduce the level of care burden and the incidence rate of end point of young and middle aged patient with stroke.