As many as 500 deaths due to stroke could be prevented each year if specialised units were introduced in hospitals, according to a new report from the Irish Heart Foundation.
It also says many survivors of stroke are left with avoidable and unduly prolonged disability because of a lack of services.
2,000 people die from stroke here every year and many more are left with disability.
The first national stroke service audit says its findings should be a 'wake up call' for the Government and that the facts are frightening.
The Health Service Executive says a number of service developments have taken place since the audit released today.
It said that dedicated beds for patients with stroke are provided in a number of other hospitals, which do not yet have a dedicated acute stroke unit.
Developments in emergency services also mean fasttracking of patients with suspected stroke, in some areas.
An evaluation of current services is being finalised by the HSE.
The Minister for Health, Mary Harney, has said that a policy review group will be making recommendations in the summer on how to prevent heart disease and stroke.
Welcoming today's IHF report, the minister said her key concern was to ensure that those at risk of stroke, or those who suffer the consequences, are provided with high quality preventative and treatment services.
Ms Harney said her department had also met with the HSE on the issue.
The IHF report found there were 32 hospitals with no stroke services and five with partial services.
The IHF says only the Mater Hospital in Dublin has a fully funded stroke unit and there are just 12 stroke unit beds in the country.
Many people die needlessly because they cannot access stroke services, it says, and others are left with avoidable and unduly prolonged disability because of a lack of services.
The report says early diagnosis and treatment for stroke, including drugs to break up abnormal blood clots and acute rehabilitation, can make the difference between life and death.
It calls for stroke units in all main hospitals and a government strategy as a matter of urgency.
