OBJECTIVES: The purpose of this study was to explore the relationship between TV/video viewing, as a measure of sedentary behavior, and risk of incident stroke in a large prospective cohort of men and women. METHODS: This analysis involved 22,257 participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported at baseline the amount of time spent watching TV/video daily. Suspected stroke events were identified at six-monthly telephone calls and were physician-adjudicated. Cox proportional hazards models were used to examine risk of stroke at follow-up. RESULTS: During 7.1years of follow-up, 727 incident strokes occurred. After adjusting for demographic factors, watching TV/video ≥4h/day (30% of the sample) was associated with a hazard ratio of 1.37 increased risk of all stroke (95% confidence interval (CI), 1.10-1.71) and incident ischemic stroke (hazard ratio 1.35, CI 1.06-1.72). This association was attenuated by socioeconomic factors such as employment status, education and income. CONCLUSIONS: These results suggest that while TV/video viewing is associated with increased stroke risk, the effect of TV/video viewing on stroke risk may be explained through other risk factors.