We have conducted a comparative analysis of medical service quality to stroke patients at the pre-hospital stage in Yuzhno-Sakhalinsk and Irkutsk. Periods of hospitalization, including periods of referral of patients (or their relatives) for medical care, arrival of ambulance personnel (AP), time spent by AP on the primary medical care and transportation of patients have been analyzed. We have analyzed periods of referral of people for medical care and assessed the volume and quality of pre-hospital therapy. The high percentage of hospitalization during the period of "therapeutic window" has been found in both cities with the significant prevalence in Irkutsk. The delay in hospitalization was caused by late referral of patients, low level of population awareness on importance of referral for urgent medical care besides the referral to AP. The number of patients transported to a hospital during the time interval (30-40 min) recommended by the WHO did not exceed 30-40% in both cities. Although the volume of medical care at the pre-hospital stage was larger in Yuzhno-Sakhalinsk, the quality of pharmacotherapy used by AP in Irkutsk was more in line with modern standards.