ABSTRACT: Background: Studies suggest that gender differences exist in the recognition of stroke warning signs. Poor recognition of stroke warning signs has been attributed to negative treatment-seeking behaviors, which can result in poor outcomes. Objective: The aim of this study was to examine gender differences in the recognition of traditional early warning signs of stroke and first action to initiate treatment in a sample of stroke survivors. Methods: We collected survey data to examine recognition of traditional stroke warning signs and appropriate first action to initiate treatment along with demographic (age, stroke age, education, usual source of care, and insurance) and clinical (health literacy and stroke knowledge) variables. Results: Seventy-one stroke survivors participated in this pilot study. Women in the sample were significantly older than men at time of stroke (62 years old vs. 55 years old; p < .05). The two groups did not differ in clinical variables. Recognition of traditional individual stroke warning signs ranged from approximately 60% to 90%. There were no significant gender differences in the recognition of individual warning signs. Women were more likely to recognize all five traditional warning signs compared with men (67% vs. 42%; p = .04). Similarly, 58% of female participants recognized all five traditional stroke warning signs collectively and would call 9-1-1 as a first action compared with only 29% of men (p = .02). Conclusions: Although women recognized traditional stroke warning signs more often than men, educational programs should emphasize both traditional and nontraditional stroke warning signs among women and address these differences with their healthcare providers.