BACKGROUND The influence of psychosocial stress on the origin of acute cerebral vascular disease (CVD) has received very little attention. The objective of this paper is to evaluate the role of psychosocial stress due to events occurring in daily life as a risk factor (RF) in acute CVD. METHODS A case-control study was done of a total of 151 patients who were admitted to two hospitals with acute CVD and 151 persons, who where not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, consumption of tobacco and alcohol and stressful incidents (SI) in their lives during the previous two years. The stress derived from SI was measured on the 'Inventory of SI and Recent Experiences' of Holmes and Rahe. The frequency of serious SI was also considered. The relative risks were estimated by the odds ratio calculations. RESULTS A positive association was found for the RF defined in relation to acute CVD. We did not find any relationship between psychosocial stress derived from SI and risk of acute CVD (either when considering scores on the Holmes and Rahe Inventory or evaluation of serious SI). CONCLUSIONS Psychosocial stress from SI does not seem to represent a RF in acute CVD.