Background: With all that is known about stroke epidemiology, however, it remains extremely difficult, if not impossible, to predict when a stroke will occur, even among those with a heavy burden of risk factors. Objective: To assess trigger factors for stroke using a case crossover design tertiary-care level hospital of Northern India . Methods: The study was conducted on patients presenting with stroke to the department of neurology of Dr. RPGMC at Tanda in Kangra district of Himachal Pradesh for a period of one year starting from September 2015 to September 2016. Results: Drug abuse, alcohol abuse, smoking, tea intake , fever, positive emotions , negative emotions and unusual physical exertion two hours prior to stroke associated significantly as triggers. Conclusion: Trauma as a trigger was not significantly associated. Coffee intake, sexual intercourse and sudden posture change were not found to trigger stroke.