Since their introduction, hormonal contraceptives have been associated with an increased risk of stroke. With newer formulations, however, the magnitude of that risk has become less clear. In this clinical summary, Drs. Sarkis Morales-Vidal, Michael Schneck, Murray Flaster, and José Biller from the Department of Neurology at Loyola University of Chicago, Stritch School of Medicine, discuss data regarding risk of stroke associated with different types of oral contraceptives. The summary also includes an expanded explanation of the possible pathophysiology of hormonal contraceptive-related stroke. Special risk groups, including women who smoke, are migraineurs, or who have arterial hypertension are specifically considered as well. In addition, a brief discussion is included regarding stroke risks associated with the ovarian hyperstimulation syndrome and stroke risks among transsexuals.