There is a high incidence of ischemic stroke and it bears a high mortality and socioeconomic charge. Advances in diagnosis and therapeutics have improved its prognosis, yet it requires urgent care. Stroke incidence shows an irregular distribution, depending on seasons, the weekly day or even the hour of the day. Knowing what factors determine this variability may be useful to develop preventive strategies and predicting moments and periods of higher incidence, as well as to adapt resources to attendance demands. In this review, we discuss the factors with a greater influence on stroke occurrence's rhythm. Main factors include daily meteorological, seasonal, psychoemotional and circadian factors related to sleep and wakefulness. Based on the reported evidence, we also discuss how each factor may influence the occurrence of ischemic stroke.