This study used standard diagnostic criteria and community-wide surveillance procedures in Auckland, New Zealand (NZ) in 1981 to 1982, 1991 to 1992, and 2002 to 2003, to assess trends in ethnic-specific stroke rates. NZ/Europeans experienced significant declines in stroke attack (19%) and incidence rates (19%) from 1981 to 1982 to 2002 to 2003. In contrast, these rates remained high or increased in other ethnic groups, particularly for Pacific peoples in whom stroke attack rates increased by 66% over the same periods. Some favourable downward trends in vascular risk factors, such as cigarette smoking, were counterbalanced by increasing age, body mass index, and diabetes in certain ethnic groups. The study concludes that Auckland has experienced divergent trends in ethnic-specific stroke incidence and attack rates in recent decades. “The findings provide mixed views as to the future burden of stroke in populations undergoing similar lifestyle and structural changes”.