Cardiovascular diseases, including stroke, are the leading cause of death in the European Union (EU), responsible for more than 4 million deaths in 2013 and accounting for 45% of all deaths. Coronary heart disease (CHD) and stroke account for the majority CVD-related deaths, with 1.8 million deaths from CHD and 1 million from stroke annually. In the past 20 years, there have been significant advances in the prevention and treatment of primary and secondary stroke. Yet there are wide disparities in the incidence of stroke and stroke-related morbidity and mortality throughout the EU, with quality dependent on a region’s uptake of these best practices. Imbalances include the percentage of patients who receive thrombolysis, are treated in stroke units, and have access to mechanical thrombectomy. To address these disparities, several organizations throughout the EU are implementing the use of registries as part of continuous quality improvement efforts designed to improve the quality of stroke care. Registries include those from the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST), which contains data on 6,500 stroke patients; the European Stroke Organisation’s registry, which sets criteria hospitals must meet to receive enhanced levels of care designation; and the Registry of Stroke Care Quality (RES-Q), a multinational, registry-based study to document the impact of improving the uptake of evidence-based interventions shown to improve the quality of stroke care and outcomes. These and other efforts to improve stroke care in the EU face numerous challenges, however, particularly the diversity of resources and health system structures in member countries. Overcoming these barriers will require that representatives of various countries learn to work together towards the common goal of reducing strokes and improving outcomes.