tPA is the standard of care for patients with 3-4.5 hours of an acute ischemic stroke who meet criteria, and yet only 50% of those eligible receive it. One of the ways to expand treatment availability is to study who gets tPA and who doesn't, in order to address the gap. To understand which segments of the population are most afflicted with the burden of stroke, and who amongst them gets tPA most frequently, and to see if there is a discrepancy. Patients who presented to any of our network of 165 hospital emergency departments with symptoms consistent with acute stroke were identified via ICD-9 codes. In addition to age, sex, and race, the tapestry segmentation category was obtained. Tapestry is a geodemographic segmentation system that integrates consumer traits with residential characteristics to identify markets and classify US neighborhoods. Internally homogenous, externally heterogeneous market segments depict consumers' lifestyles and lifestages. Tapestry Segmentation combines the “who” of lifestyle demography with the “where” of local geography to create a classification model with 67 distinct, behavioral market segments. 93,877 patients were in the cohort, which was 52% female. 6092 patients got tPA, for a rate of 7.6% after excluding intracranial hemorrhages. 73% were White, and 16% Black. The median age was 70, with an interquartile range of 58 to 80. 65% were Medicare. 44% were ultimately discharged home, 11% were sent to a skilled nursing facility, and 6% expired. In terms of tapestry segmentation for having a stroke, the 2 largest groups who had a stroke were 7C and 10A (8%), whereas the groups that got tPA most frequently were groups 7A and 2C (23%). Group 7C are termed “American Dreamers” and consists of 1.7 million households with a median income of 48K. Most are married couples with children of all ages or single parents; multigenerational homes are common. Most residents derive income from wages or salaries, but the rate of poverty is a bit higher in this market. Apprioxmately 63% hold only a high school diploma. Group 10A, termed “southern satellites” consists of of 3.7 million households with a median income of 44K. Their median age is 39.7. This is typically a nondiverse market, where 1/3 are mobile homes. Married couples with no children are the dominant household type, with a number of multigenerational households. 40% have a high school diploma only. Group 7A, within termed “up and coming families” is one of the 2 groups that got tPA most often consists of more than 2.5 million up and coming families, with a median income of 64K and 66% college educated. Group 2C, the other group to receive the highest rates of tPA, represents the “urban chic,” consists of 1.5 million households with a median age of 42.6, median income of 98K, and 60% are college educated. Compared to 7A, this group makes higher median income and is slightly older, but the thing the groups both have in common is that they are ambitious, working hard to get ahead, and willing to take some risks to do so. tPA is given most often in young ethnic families as well as the urban chic. Compared to the groups in which strokes occur the most often, the groups that received tPA are better educated, have a higher employment rate, and a significantly higher income. Understanding the mapping of strokes vs. strokes that get tPA beyond simple characteristics such as sex and race may be helpful in helping to plan community based support programs for active treatment of stroke.