The study objectives are to: First, delineate the global spatial distribution of alcohol-related stroke; Secondly, To explore the potential impact of biological mechanisms (e.g., ALDH2 gene polymorphisms) and social factors (including regional drinking culture) on age- and sex-specific burdens; moreover, By analyzing regional variations in stroke incidence and outcomes, this study investigates the impact of alcohol control policies on the burden of stroke, thereby offering potential optimized policy recommendations for the WHO Global Framework for Action on Alcohol Control (2022–2030). Here, ALDH2 is linked to Stroke.