An epidemiologic study was made of cerebrovascular disease in a biracial semirural community in Georgia. During an 87-month period, 94 of the 3,000 persons studied developed their first cerebrovascular event. The incidence of stroke among white men (4.7/1,000/year) was almost four times that in white women and more than twice that reported for white men in other sections of the country. The incidence rates of stroke in black men and women were equal (5.8/1000/yr). The risk factors predisposing to stroke in white men appeared to be severe hypertension, obesity, high hematocrit levels, and electrocardiographic abnormalities. The high incidence of cerebrovascular disease in this study supports previous reports of increased mortality for stroke in this region and represents an unusual situation with an undetermined cause.