Abstract: Objective To explore the relationship between rehabilitation exercise adherence, health beliefs and family care in stroke patients, as well as the influencing factors. Methods A total of 201 stroke patients treated in the Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, from November 1, 2024 to January 25, 2025 were enrolled in this study. Among them, 130 were male and 71 were female, with a mean age of （64.2±13.3） years. A questionnaire survey was conducted using a general information questionnaire, the Exercise Adherence Questionnaire （EAQ）, the Short Form Health Belief Model Scale （SF-HBMS） and the Family Adaptation, Partnership, Growth, Affection, Resolve Index （APGAR） for the stroke patients. The differences of measurement data with normal distribution between groups were compared using t-test or one-way analysis of variance. The relationships between rehabilitation exercise adherence, health beliefs and family care were analyzed by Pearson correlation analysis. The influencing factors of rehabilitation exercise adherence were analyzed by multiple linear regression analysis. Results The stroke patients showed an overall moderate level of rehabilitation exercise adherence, with an adherence index of （65.21±16.48） %. Specifically, 33.8% demonstrated high adherence, 45.8% moderate adherence and 20.4% low adherence. Health beliefs were at a moderate level, with a score of 71.24±12.39. Family care was overall good, with a score of 7.39±2.42, and 68.6% of the patients demonstrated good family functioning. Stroke patients showed a positive correlation between rehabilitation exercise adherence and both health beliefs （r = 0.701, P < 0.01） and family care （r = 0.659, P < 0.01）. Health beliefs were also positively correlated with family care （r = 0.673, P < 0.01）. Multiple linear regression analysis indicated that health beliefs, family care, age, employment status and self-care ability were the main factors influencing rehabilitation exercise adherence, collectively accounting for 61.6% of the variance in adherence （F = 18.795, P < 0.001）. Conclusions Stroke patients exhibit a moderate level of rehabilitation exercise adherence. Health beliefs and family care are the significant influencing factors for the adherence to rehabilitation exercises.