Abstract: Severe changes in meteorological conditions can increase the incidence of stroke in people at risk. In this study, daily stroke hospitalization data and meteorological data in Tianjin are collected from 2016 to 2020, and the cumulative probability distribution of daily stroke hospitalization is used to classify the hospitalization risk grades. The high-impact meteorological factors are determined through correlation analysis, and the distributed lag nonlinear model and semi-parametric generalized additive model are used. The impacts of time-scale change and lag and cumulative effects of high-impact meteorological factors on the risk of stroke hospitalization are investigated. The results show that the number of stroke inpatients in Tianjin is about 225,000 per year, with the highest number of monthly inpatients reaches 21,000 and the average daily inpatients are 623. The proportion of male and female hospitalized is 8:5, and the population over 50 years old is the high-risk population prone to stroke disease. Late autumn (October to November), early winter (December) and spring (March to May) are the high-risk periods of stroke hospitalization in Tianjin. The risk of stroke hospitalization can be increased by the superposition of monthly temperature change above 6℃ and 24 h negative temperature change above 6℃, and the risk of stroke hospitalization is the highest when the monthly temperature change is negative. Both high temperatures above 30℃ and low temperatures below −5℃ can cause high risk of stroke hospitalization. The risk of stroke hospitalization caused by low temperature is higher than that caused by high temperature. The effect of low temperature reaches the strongest with 2 to 3 d lag. The risk of hospitalization is higher with negative temperature change within 24 h than with positive temperature change, and the larger the temperature variation, the higher the hospitalization risk. The risk of hospitalization is the highest with 24 h negative temperature change above 7℃ with a lag of 3 to 5 d. The meteorological reasons for the high hospitalization risk of stroke in Tianjin are mainly the superposition of monthly and daily temperature changes, followed by the influence of extreme temperature and 24 h temperature change.