Stroke is a leading cause of death and serious long-term disability worldwide, with an estimated global prevalence of over 104.2 million people. With about 6.2 million deaths attributed to cerebrovascular diseases annually, ischemic/haemorrhagic strokes remain major threats to public health. There is no indication that these numbers changed significantly despite advances in modification of risk factors and specific preventive treatment of some etiologic factors. One major challenge is the highly heterogenous nature of potential causes of stroke, which require a concerted multidisciplinary approach to design and conduct of clinical prevention trials. Failures in such clinical trials have been exceedingly more common than successes, an important fact that points to the need for improvement in their design/conduct through better collaboration among the major stakeholders: the academia, government-based funding and regulatory organizations and the industry.