BACKGROUND: Since information about the association between serum albumin and risk of stroke is limited the purpose of the present paper was to re-investigate this relationship. DESIGN: The study followed a cross-sectional design. METHODS: In the cross-sectional Norwegian Oslo Health Study the concentration of serum albumin and blood pressure was determined in a random sample of 5071 men and women, 30-75 years of age. Logistic regression was used to study the association between the serum albumin concentration and self-reported prevalence of stroke. In the sample there were 122 subjects with a history of stroke and 4949 subjects without. RESULTS: Low albumin (i.e. 47 g/l) was associated with increased prevalence of self-reported stroke (odds ratio 1.83; 95% confidence interval, 1.20-2.78; P=0.005), after adjusting for age ( or =59 years) and sex. Including smoking, blood pressure and length of education into the model did not have any major influence on the result. CONCLUSION: Low serum albumin is associated with increased prevalence of self-reported stroke.