BACKGROUND: Cerebrovascular accidents ("stroke") have enormous public health impact in regard to mortality, disability and long-term dependency from care. The role of aircraft noise as a presumed risk factor for cerebrovascular morbidity and mortality is still unresolved. OBJECTIVE: To evaluate whether individuals exposed to environmental civilian aircraft noise are at an elevated risk of fatal or non-fatal cerebrovascular accident. METHODS: We performed a systematic review and a meta-analysis. The study design has been previously published with the International Prospective Register of Systematic Reviews (PROSPERO) on December 11, 2013 (registration number CRD42013006004) and can be accessed on the PROSPERO website. An extensive systematic electronic literature search was conducted in MEDLINE, EMBASE and BIOSIS, supplemented by a comprehensive hand search. In a three-step iterative process, titles, abstracts and full-texts of studies identified in the search were screened for eligibility by two reviewers independently. Study quality appraisal was performed and data extracted. Currently the meta-analysis is being processed. RESULTS: 17 reports (7 studies) met our inclusion criteria for stroke as an endpoint, data of 6 studies will be considered for meta-analysis. As a result of the descriptive synthesis, just one study could find a monotone exposure-response-relationship with a risk estimate of 1.24 (95% CI 1.14-1.46) for noise exposure >63 dB between 7am and 11pm. Particular conclusions as to conceivable exposure-risk trends are subject to the results of the meta-analysis which is currently conducted. Results of the meta-analysis will be presented at the conference.