Purpose Few studies have reported changes in the accumulation patterns of physical activity over a year after stroke. This study characterized the longitudinal changes in physical activity levels and their accumulation patterns for a 1-year follow-up period in stroke survivors. Materials and methods In this single-center, prospective, longitudinal observational study, 47 stroke survivors were assessed at rehabilitation discharge and at 6 and 12 months post-discharge. Physical activity was evaluated, and measures included the number of steps, walking duration, total number of bouts per day, and intensity (light, moderate-to-vigorous) and spread (short, medium, and long bouts). Results There were no significant main or interaction effects of time on any physical activity variables. Light physical activity accounted for 90% of all walking bouts and 70% of walking duration. Regarding moderate-to-vigorous physical activity (MVPA), 85% of walking bouts and 35% of walking duration were accumulated in short and medium bouts. The number of long-bout MVPA was three per day. Conclusions Physical activity levels and accumulation patterns were highly stable throughout the 12-month follow-up period. Accumulating light physical activity and intermittent MVPA is important for maintaining physical activity levels in stroke survivors. These findings will promote a better understanding of disability and rehabilitation practice. IMPLICATIONS FOR REHABILITATION Physical activity levels and accumulation patterns were highly stable throughout the 12-month follow-up period. The accumulation of moderate-to-vigorous physical activity in long bouts might be challenging for stroke survivors. Accumulating light physical activity and intermittent moderate-to-vigorous physical activity may be acceptable for stroke survivors.