It would be valid to conduct prophylaxis of acute cerebrovascular disturbances (ACVD) in the context of state integral program of prophylaxis of the main noninfectious diseases. Its basic principles are: control of risk factors, integral approach and priority of populational strategy. The main medical directions of ACVD prophylaxis are: control of arterial hypertension and prevention of cardioembolic insult in patients with heart rhythm disorders. It is also possible to prevent repeated ACVD in patients with transitory ischemic attacks and minor insults. The best result is prognosed in combination of the state policy of providing the healthy mode of life of population and medical prophylaxis of ACVD in high risk groups.