Introduction: Disparities in access to acute stroke care represents a major global challenge. Addressing such challenges requires a comprehensive understanding of the variations in stroke care quality between nations. Methods: We used data from the global Registry of Stroke Care Quality (RES-Q). RES-Q is web-based quality monitoring platform for the management of stroke care. Key quality metrics on patients with acute ischemic stroke admitted in 2022 were calculated: patients percentage arriving by Emergency Medical Services (EMS); patients percentage admitted to the Stroke Unit/Intensive Care Unit (ICU); Door-to-Imaging Time (DIT), Door-to-Needle Time (DNT) for intravenous thrombolysis. Results: Of 153 181 patients across 912 hospitals in 67 countries enrolled in the register, 125 390 had acute ischemic stroke. After excluding secondary transfers (n=26 648), missing or erroneous data (n=45 526), and countries with <200 cases (n=1 410), a total of 51,806 patients from 696 hospitals and in 30 countries were analyzed. The percentage of patients arriving at healthcare facilities by EMS varied from 3% to 98% (median 51%; IQR 26-87) and admitted to the Stroke Units/ICUs from 25% to 99% (median 78%; IQR 47-89). The median DIT was 32; IQR 21-39, with range 10-60 minutes. The median DNT was 44; IQR 31-52, with range 20-71 minutes. Median DNT of patients admitted directly to the CT scanner was 24 minutes (IQR 15-38), and, if admitted to the emergency department, DNT was 39 minutes (IQR 25-55). Data by quartiles (best is blue, worst is red) from each country are presented in a detailed Table below. Conclusion: Our study underscores the critical role of the global registry in enabling cross-national comparative analyses of acute stroke care quality. The findings highlight disparities and variations in critical aspects of acute stroke care, paving the way for targeted interventions, policy reforms, and enhanced collaboration among stakeholders to improve stroke care globally.