Stroke is one of the leading causes of acquired disability, the second cause of dementia after Alzheimer's disease, and the third cause of mortality after the ischemic heart diseases, which altogether make them, therefore, a public health priority. The rapid and adequate management (diagnosis and multidisciplinary care) and keeping cardiovascular risk factors well-controlled (e.g: arterial hypertension) can help to reduce the incidence of stroke-related death. The study aims to identify factors associated with stroke mortality in low middle-income countries, especially in the Eastern region of the Democratic Republic of Congo. We used a prospective neurosurgical registry based on Research Electronic Data Capture (REDCap) to systematically collect variables spanning 6 categories. Univariate and multivariate analyses were conducted to determine significant predictors of mortality. One hundred and eighty (180) patients with stroke were included. Stroke related mortality was 57/180 (31.7 %). Variables predictive of mortality were the advanced age with a female predominance, poor compliance to antihypertensive, and anti-diabetic medication, recurrent stroke, alcoholism, and chronic smoking, obesity, hemorrhagic stroke, use of estrogen-progesterone pills by women, as well as the delayed management. Stroke is a common cause of mortality in Butembo. Prevention measures, and efficient specialized care for stroke, especially targeting modifiable prognostic factors, can help to reduce mortality significantly.