Stroke specialists say services have improved but more work needs to be done to ensure patients are managed in the best way possible.
A study in the latest issue of the New Zealand Medical Journal says only about a quarter of patients are treated in special hospital stroke units.
Strokes are the third most common cause of death and the leading cause of adult disability.
The 2008 study shows access to stroke unit care and to treatment to breakdown blood clots is low, partly because there weren't enough units to provided the urgent treatment needed.
Specialists say a major effort is under way, involving the Stroke Foundation, but there's still scope for improvement.
The Health Minister Tony Ryall says networks of family doctors, ambulances and hospitals doubled recovery rates in New South Wales - and that's the goal in New Zealand.