Background: In Ivory Coast, as in many tropical regions, there is a significant coexistence of infectious diseases and non-communicable diseases (NCDs), particularly within the field of neurology. The dual burden of neuroinfectious diseases, including meningitis and strokes, plays a crucial role in shaping public health strategies implemented by the World Health Organization (WHO) and national health programs. Unfortunately, the epidemiological trends are not regularly updated. This study aims to provide insights into hospital admissions and mortality related to strokes and brain infections to inform health policies and improve disease management. Method: It was a retrospective study that examined the medical records of patients admitted to the neurology department of the Cocody University Hospital in Abidjan from January 1, 2020, to December 31, 2023, and included individuals across all age groups who were diagnosed with stroke, brain abscess, meningitis, or encephalitis. Results: The study involved 1,518 patients, strokes were more common among older adults, with an average age of 57.3 ± 13.7 years. Strokes represented the primary reason for hospitalization, making up 69% of cases, with an annual growth rate of approximately 2%, while neuroinfectious diseases accounted for 13% of total admissions. In-hospital mortality rates were 15% for stroke patients and 28% for those with neuroinfectious diseases, the latter showing a significantly higher mortality risk (odds ratio = 2.50; p < 0.001). Conclusion: Strokes are the leading cause of hospital admissions in our department, with increasing rates; however, neuroinfectious diseases have higher and stable mortality rates, indicating a more severe prognosis. Therefore, health policies must be reassessed to improve prevention and management for both diseases.