Background and Purpose: Influenza may be associated with stroke risk. We hypothesized that risk of ischemic stroke is increased after influenza-like illness (ILI), and that these effects are even greater for those in an urban environment, of Black race, and male sex. Methods: A case-crossover analysis of the 2012-2014 inpatient and outpatient New York Statewide Planning and Research Cooperative System (SPARCS) was used to estimate the odds of hospitalization for ischemic stroke after hospitalization for ILI. Each patient’s case window (the time period preceding stroke) was compared to their control windows (constructed using the same dates from the previous two years) in conditional logistic regression models used to estimate odds ratios and 95% confidence intervals (OR, 95% CI). We varied the case windows from 15 to 365 days. Analyses were stratified by urban and rural status based on residential zip code, sex, and race. Results: A total of 30,912 patients were identified as having an ischemic stroke in 2014 and included in the study (49% male, 20% Black, 84% urban, mean age 71.9 [SD 14.7] years). ILI in the 15 days before a stroke was associated with an overall increase in odds of stroke (OR=1.39, 95% CI 1.09-1.77), and this association remained over time (Table). There was no significant interaction between ILI and urbanicity (p=0.29), sex (p=0.81), or race (p=0.85). Conclusion: ILI was associated with stroke risk, but there was no evidence of race, sex or location differences in the relationship between ILI and stroke.