Purpose Patients with end-stage heart failure on left ventricular assist devices are predisposed to stroke. Preoperative factors associated with increased stroke risk are poorly understood. Methods Single-center retrospective review of 725 patients from 2000 to 2017 who received a continuous flow left ventricular assist device (CF-LVAD) at our institution. Logistic regression analysis was performed to determine independent predictors of ischemic and hemorrhagic stroke . Results Mean age was 54.0±13.7 years, most patients were male 573 (79.0%), and most were implanted as a bridge to transplant 421 (58.1%) (Table 1). Of these, 118 (16.3%) patients had an ischemic stroke at a median follow-up of 128 (Range:1-4042, IQR 36-456) days. A history of diabetes was independently associated with an ischemic stroke (HR 1.7 95% CI 1.1 to 2.6, p=0.01). Hemorrhagic stroke , excluding ischemic conversions (N=16, 2.2%), occurred in 86 (11.9%) patients at a median follow up of 281 (Range:5-2436, IQR 92-698) days. Female gender (HR 1.9 95% CI 1.1 to 3.4, p=0.02) and INTERMACS class I (HR 2.2 95% CI 1.3 to 3.7, p=0.04) were independently associated with development of hemorrhagic stroke while on CF-LVAD support. Patients with ischemic and hemorrhagic stroke had significantly lower survival compared to patients without postoperative stroke (Figure 1). Conclusion The temporal pattern and risk factor profile for ischemic stroke is distinctly different from that of hemorrhagic stroke in patients on CF-LVAD support. This may be useful in preoperative risk stratification and postoperative risk reduction.