Stroke is a condition that affects a significant proportion of the world's population, leading to a number of sequelae. The cost of stroke care is still unknown in many countries. The objective of this study is to evaluate the direct hospital cost of stroke management in Libreville, Gabon. This is a retrospective economic study including patients hospitalised for stroke at the CHUL over a 24-month period from January 2014 to December 2015. 280 cases were included in the study, with a mean age of 58.27 (±13.58). We recorded 63 (22.5%) cases of haemorrhagic stroke and 217 (77.5%) cases of ischemic stroke. The direct hospital cost of managing a stroke was 715,122 CFA francs, i.e. a total cost for all patients of 200,234,160 CFA francs (305,235 euros). The cost per patient of a haemorrhagic stroke was 864,944 CFA francs and 671,625 CFA francs for ischaemic stroke. The cost of stroke management is high. In view of the purchasing power of the Gabonese people, we suggest better insurance coverage and a national policy to subsidise care.