Abstract: Objective To screen the high-risk population of stroke by family doctors in Shanghai Xinhong Community, to analyze the screening results and the cost, and to provide the policy basis for community prevention and control of stroke in urban areas. Methods According to the jurisdiction area of each family doctor, 100 families with hypertension were randomly selected, and 2 760 residents aged 35 years and above were investigated. Using the unified screening questionnaire to survey risk factors, 2 693 people completed the questionnaire, with 868 high risk population to further complete assessment questionnaire and exam on the serum homocysteine (Hcy) and the bilateral carotid ultrasonography in hospital. Results A total of 868 high-risk population people were screened by questionnaire, the detection rate was 32.23%. Serum Hcy test results:low Hcy 140 people (16.13%), middle Hcy 424 people (48.85%), and high Hcy 304 people (35.02%). The bilateral carotid ultrasonography results:fresh arterial plaque for 548 people (63.13%), carotid artery stenosis and 19 (2.19%).The average cost of screening 1 case was 16.54 yuan; the average cost of 1 high-risk groups was 51.32 yuan; the average cost of screening 2 items was 93.54 yuan. Conclusion The risk factors of stroke in hypertension family members were exposed to a higher level; Family health management of people with chronic diseases should be the focus by family doctors, especially on the male residents over the age of 50.The cost management should be strengthened to improve the profit of screening.