BACKGROUND: Hydrocarbon exposure, including polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), is increasingly linked to vascular dysfunction and stroke, a leading cause of morbidity and mortality globally. Common in occupational and environmental contexts, hydrocarbons induce oxidative stress, systemic inflammation, and endothelial dysfunction, disrupting vascular health. This systematic review examines the association between hydrocarbon exposure and stroke, emphasizing specific metabolites and their cerebrovascular effects. METHODS: A comprehensive search across PubMed, Embase, and Web of Science was conducted through December 10 2024, identifying observational studies exploring hydrocarbon exposure and stroke risk. Studies meeting predefined inclusion criteria, excluding those with major methodological flaws, were synthesized narratively. Variations in hydrocarbon types, population demographics, and stroke outcomes were considered. RESULTS: Six studies, including five cross-sectional and one retrospective cohort, with sample sizes ranging from 5,537 to 283,666 participants, demonstrated significant associations between hydrocarbon exposure and stroke risk. Key findings revealed strong associations for metabolites like 1-hydroxynaphthalene (OR: 1.89; 95% CI: 1.62-2.20) and 2-hydroxyfluorene (OR: 1.94; 95% CI: 1.66-2.26). However, variability in findings was noted, attributed to differences in study design, exposure levels, and populations studied. CONCLUSION: This review highlights a complex relationship between hydrocarbon exposure and stroke risk, with some studies indicating significant associations and others reporting inconsistencies. Standardized, large-scale research is essential to clarify this relationship, identify high-risk populations, and guide public health strategies to mitigate exposure and prevent stroke. CLINICAL TRIAL NUMBER: Not applicable.