Stroke is a leading cause of death and adult disability in the Western world. Diet is an important consideration as there is evidence that around half of stroke patients are undernourished on admission to hospital and their nutritional status often declines during the hospital stay. Undernutrition is associated with both increased morbidity and mortality. There have been many studies that have looked at various aspects of feeding in stroke patients, and guidelines are available for clinicians and healthcare workers involved in the care of stroke patients. The present paper aims to review current evidence underpinning guidelines on nutritional management of stroke patients, identify potential barriers to implementation and highlight areas for future research. © 2007 The Authors; Journal compilation © 2007 British Nutrition Foundation.