To systematically evaluate the key driving factors of health-promoting behaviors in stroke patients. Methods: Qualitative studies related to health-promoting behaviors in stroke patients were retrieved from databases such as CNKI, Wanfang, VIP, PubMed, Scopus, Web of Science, Cochrane, CINAHL, EMBase, PsycINFO, and Sinomed, up to December 2023. The quality of the included studies was evaluated using the JBI's quality appraisal tools for qualitative research in evidence-based healthcare, and a meta-synthesis was conducted on the themes extracted from the included studies. Results: A total of 9 studies were included in this study, yielding 52 themes. These themes were ultimately summarized into 2 synthetic findings and 10 categories. Conclusion: The transition to health-promoting behaviors in stroke patients is the result of the combined effects of multiple factors.