Returning to work has been identified as an important rehabilitation goal following stroke. Twenty percent of stroke survivors are of working age. The purpose of this systematic review was to determine the effect of vocational rehabilitation programs on return-to-work rates post stroke.Searches were performed in electronic databases and Web-based sites. Studies were eligible for inclusion if they included an adult population of working age (18 to 65 years) who had survived a stroke and had participated in a vocational rehabilitation program. The exclusion criteria included any other type of rehabilitation that did not specifically address vocation, other diagnostic groups or studies where stroke population results were not reported independently, as well as publications not translated to English. The primary outcome was return-to-work rates.Six studies, involving a total of 462 participants, were included in this review. All studies were a retrospective single cohort design. The rates of employment following these vocational rehabilitation programs ranged from 12% to 49%.There was not an adequate number of high-quality trials to make recommendations that support or refute the use of specific vocational rehabilitation programs to increase return-to-work rates following a stroke. Standardized terminology definitions as well as quality, randomized controlled trials are required before conclusions can be made about the effect of vocational rehabilitation programs on the return-to-work rates for stroke survivors.