No commonly agreed definition exists for stroke symptom knowledge among members of the general public. Recalling at least one correct stroke symptom has been used in the past. However, this criterion was not associated with rapid presentation to hospital. Rapid presentation is vital in order to provide effective acute stroke treatment. AIMS AND/OR HYPOTHESIS: We sought to identify a base level of community stroke symptom knowledge associated with stroke recognition when symptoms occur, an immediate ambulance call, and stroke recognition and immediately calling an ambulance as a single sequence of events. METHODS: For six-months in 2004-2005, we identified all patients with stroke living in a defined region of Melbourne and who were transported by ambulance to one of the three hospitals. The person who called the ambulance (caller) was interviewed. RESULTS: One hundred ninety-eight patients were identified and 150 callers interviewed. Symptoms reported most frequently were limb weakness (67 ), speech problems (57 ), and facial weakness (24 ). Reporting at least two of the symptoms - facial weakness, limb weakness, or speech problems (62 of callers) - was associated with stroke recognition (P?=?0?004), immediately calling an ambulance (P?=?0?065), and both stroke recognition and immediately calling an ambulance (P?=?0?053). CONCLUSIONS: Knowing at least two of the symptoms - facial weakness, limb weakness, and speech problems - appears to be an appropriate indicator of stroke symptom knowledge as it is associated with stroke recognition and appropriate action. Recognizing stroke symptoms and immediately calling an ambulance increase the potential to reduce prehospital time delays and improve eligibility of acute stroke patients for rapid treatment.