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The percentage of stroke deaths attributable to low temperature was 7.23% in 2019, accounting for 474,002 stroke deaths globally, while about 48,030 of the stroke deaths were attributed to high temperature. Joinpoint regression analysis was applied to calculate the average annual percent change (AAPC) with 95% confidence interval (CI) to evaluate stroke mortality trends in 1990–2019. Trends from global stroke mortality attributed to low temperature significantly declined (AAPC = −2.5%; 95%CI = −2.6 to −2.3) in both sexes together. A significantly increased trend for stroke mortality attributed to high temperature was observed in both sexes together (AAPC = +1.0%; 95%CI = 0.6 to 1.3).