Abstract: Objective To explore the current status of care ability in stroke patients' main caregivers and the effect of care preparedness and adult attachment. Methods There were 223 qualified caregivers collected from Department of Neurology of two tertiary hospitals in Zhejiang province between July 2018 and January 2019 by convenience sampling. The basic data questionnaire, care preparedness scale, experiences in close relationships questionnaire and comprehensive care ability questionnaire of stroke patients' caregivers were used in the investigation. The data were imported into SPSS 22.0 software. T-test and ANOVA were used to analyze the influencing factors of care ability, and the statistically significant variables were included in multiple linear regression analysis. Results The score of care preparedness was 15.31±4.87. The scores of attachment anxiety and attachment avoidance were 3.28±0.76 and 3.52±0.83 respectively. The number of safe attachment was 102(45.7%). The score of care ability was 95.64±23.47. The regression results showed that care preparedness, total time of care, self-care degree of patients, safe attachment and educational level could affect the care ability of the main caregivers of stroke(F=28.442, P<0.001), which could explain 55.3% of the total variation. Conclusion Medical staff should pay attention to the care ability of the main caregivers of stroke patients, help them improve care preparedness, adopt individualized training methods according to their different types of attachment and educational level, and improve the quality of life of stroke patients' and caregivers.