AIM This study aimed to assess the degree of patient compliance with medications prescribed at hospital discharge following ischaemic stroke, and concordance between self-reported medication use and general practitioner (GP) records. METHODS The Auckland City Hospital Stroke database was used to identify consecutive patients with ischaemic stroke over a three-month period. Participants were contacted and invited to participate in a telephone questionnaire that asked about current medications. GPs were also asked to list the medications their patients were taking. RESULTS Fifty-one patients were approached to participate of whom 48 consented to be interviewed at 6 weeks and 47 at 6 months. At 6 weeks, 36 of 38 (95%) were compliant with aspirin, 12 of 13 (92%) dipyridamole, 8 of 9 (88%) warfarin, 36 of 41 (88%) statins, 33 of 38 (87%) antihypertensive medications, and 7 of 7 (100%) diabetes medications. At 6 months, 97% were compliant with aspirin, 100% dipyridamole, 100% warfarin, 94% statins, 91% antihypertensive medications, and 100% diabetes medications. Natural or herbal remedy use was reported by 10 of 48 (21%) at 6 weeks and 11 of 47 (23%) at 6 months. Blister packs were used by 8 of 48 (17%) at 6 weeks and 5 of 47 (11%) at 6 months. CONCLUSION Adherence to secondary stroke prevention medication was between 87% and 100% at 6 weeks with similar findings at 6 months after discharge. We speculate that these high compliance rates may be due to one-on-one stroke nurse counselling and the use of stroke information packs, which include information about the importance of adherence to secondary prevention medication.