Family history is a known non-modifiable risk factor of stroke. We aimed to compare the frequency of a family history of vascular disease between ethnic South Asian and Chinese stroke patients. We studied consecutive ethnic South Asian and Chinese ischaemic stroke patients matched for age, gender and presence of diabetes. Among the 152 matched pairs, ethnic South Asian ischaemic stroke patients had a higher frequency of vascular family history (IHD OR 3.465 p<0.001; CVD OR 1.754 p=0.059; and either IHD or CVD OR 2.169 p=0.003) compared to matched ethnic Chinese patients, independent of past IHD history and stroke subtype. In the ethnic South Asian cohort, patients < or = 60 years old had a higher frequency of a family history of IHD (37% vs 13%, p<0.001), CVD (34% vs 15%, p=0.005) and either IHD or CVD (52% vs 25%, p<0.001) compared to those >60 years. Family history of vascular disease is common among ethnic South Asian ischaemic stroke patients, particularly among those < or = 60 years old. We postulate that the higher frequency of a vascular family history among ethnic South Asians compared to ethnic Chinese may be explained by genetic, environmental and lifestyle influences, or interactions between these factors.