Abstract: OBJECTIVE To investigate the cost-effectiveness advantage of medication therapy management(MTM) service in neurology on secondary prevention of stroke patients. METHODS The patients in the department of neurology of Beijing Friendship Hospital, Capital Medical University from September 2017 to August 2019 were divided into MTM group and control group. After returning from the hospital for three months, the secondary prevention, treatment cost and adverse reactions were recorded. Treeage pro 11 was used for cost-effectiveness analysis. A single MTM service charge of 50.00 yuan was set. The study period was 10 years and the annual discount was 3%. The average hospitalization expenses of acute events with recurrent stroke were calculated according to the volume of China Health Statistics Yearbook in 2018. The willingness to pay of patients' was 3 times that of 10-year MTM service cost of 6 000.00 yuan as the cost-effectiveness threshold. RESULTS A total of 315 patients were included, 158 in MTM group and 157 in control group, and 28 persons lost to follow-up. Finally, 143 cases were included in the MTM group and 144 cases in the control group. The medical costs of MTM group before and after service were(1 435.03±964.35) yuan and(819.21±756.86) yuan respectively, while those of the control group were(1 314.20±931.97) yuan and(896.53±659.45) yuan, respectively. The medical costs in the simulated 10 years were 34 855.82 yuan and 24 173.77 yuan, while the corresponding quality adjusted life year(QALY) were 32.69 years and 17.34 years, respectively. Compared with the two groups, MTM group was the superior scheme, and the incremental cost-effectiveness ratio was 696.08 yuan/QALY. CONCLUSION As a paid pharmaceutical care model abroad, MTM service has achieved good results in pharmaceutical care, and its development in China is still in its infancy. This study assumes that MTM is a paid service for research, and finds that clinical pharmacists to carry out MTM service can improve the secondary prevention effect of stroke patients, improve the prognosis of patients, and has economics advantages.