Stroke is one of the three most common causes of death and the sixth most common cause of disability worldwide. Building effective and efficient stroke care systems is critical for improving patient outcomes in the prevention, treatment, and rehabilitation of stroke. A systems approach is necessary to improve the way stroke is treated so that patients have access to the most appropriate treatment in centers that are best equipped to deal with their critical and time-sensitive needs. System simulation has much to contribute to the design and operation of effective and efficient stroke care systems. The success on this path depends, among other factors, upon common vision for problems to attack. The objective of this paper is to review existing contribution of simulation modeling to stroke care systems and to propose the ways for future contribution of system simulation to the effort of designing and operating effective stroke care systems.