This study is aim to determine the direct costs of hospitalisation for stroke inpatients in Pudong New Area, by analysing the composition and trends, and identifying influencing factors, to inform the development and implementation of relevant policies and strategies. This study included hospitalized stroke patients and obtained 1,3061 valid samples. We used a self-designed questionnaire to collect direct cost data for stroke patients from the Regional Health Information Platform of Pudong New Area. We collected information on 28 variables, including admission route, stroke subtype, and costs for hospitalization, consultations, and treatments. The data came from medical institutions in Pudong New Area from 2016 to 2020. The study subjects had an average age of 71.69 ± 13.11 years, with 56.8% being men and 43.2% being women. Among them, 15.5% had haemorrhagic strokes, 84.3% had ischemic strokes, and 0.2% had undifferentiated strokes. The highest costs were attributed to oxygen therapy, medication, and examinations. The results of the study also describe trends in the movement of various types of costs. In Pudong New Area, Shanghai, hospitalized stroke patients, particularly older men after an ischemic stroke, have higher likelihood. The main cost factors include oxygen therapy, examinations, and medications. It is crucial to pay attention to the trends in the costs of oxygen therapy, nursing, and medications. Age, length of stay, and stroke subtype have an impact on the total hospitalization costs, emphasizing the importance of the pre-treatment and recovery periods for cost reduction efforts.