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Background: Stroke and cardiovascular diseases are the leading causes of death in Asian-Americans. Elderly Korean-Americans have a higher prevalence of stroke risk factors than elderly Caucasians, including uncontrolled hypertension and diabetes. Yet, little is known about the level of stroke knowledge Korean-American seniors possess, the impact of cultural remedies and health beliefs, and where Korean-American seniors obtain health information. Methods: A Community Advisory Panel of 7 Korean-American community and health care leaders was created to guide the research process, including approving translations and interpreting results. We recruited 64 Korean-American seniors from an adult day health care center and 98 from a large church, both in the Los Angeles area. Subjects met on-site at the facility and completed a written survey in Korean containing 6 open-ended questions about stroke including risk factors (RFs), symptoms (Sx), what to do when having a stroke, knowledge of any acute stroke therapies or time limit for therapies, and sources of stroke information. Other variables assessed were demographic information and comfort with English. Subjects were told to skip questions if they did not know the answer. Verbatim Korean responses were translated to English by bilingual study team members; 3 coders sorted responses into categories. Results: Mean age was 74.9 years old; 68.5% were female. Two of 162 subjects indicated they felt very comfortable speaking English; 53.1% were not comfortable speaking English. Regarding stroke RFs, 53.7% wrote correct responses, i.e. hypertension; 6.8% listed incorrect RFs, including culturally significant causes such as blackening of blood; 5.6% stated “I don’t know” and 33.9% chose not to answer. Regarding stroke Sx, 12.3% of subjects correctly identified Sx, 35.2% subjects listed stroke RFs, 6.1% wrote “I don’t know” or an illogical answer, and 45.7% left their answer blank. Sources of stroke information included physicians or community health centers (21.6%); television or newspapers (18.5%); and interpersonal relationships (9.3%). While 43.2% of subjects wrote to contact emergency medical services when someone was having an acute stroke, the next most common responses (6.2%)were culturally traditional emergency treatments, such as blood-letting and ingesting Oriental herbs; 50% either wrote they did not know or left it blank. 6.8% of subjects had correct knowledge of acute stroke treatments; 3.1% of subjects listed acute cultural remedies as acute stroke therapy; rest of subjects wrote “I don’t know,” or did not answer. Only 31.5% identified a time window of less than 3 hours to treat stroke. Conclusions: Korean-American seniors lack knowledge about stroke risk factors, symptoms, and response. Most elderly Korean-Americans are uncomfortable speaking English, and cultural traditional remedies are sometimes performed in lieu of seeking emergency Western medical treatment. Interventions to prevent and improve acute stroke response in Korean-American elderly communities must not only fill a knowledge gap, but also address significant cultural misperceptions about stroke and involve local community leaders and peers.