Objectives Stroke is the main health problem of the elderly in the world. The disease may create a spiritual crisis in the person. The purpose of this study was to investigate the relationship between prayer and spiritual health of elderly patients with cerebrovascular accidents (CVA).  
Methods & Materials In this correlational study, 142 patients with CVA were investigated in the Neurology Department of Bou Ali Sina Hospital in Sari City, Iran. Data collection was done by Ellison and Paloutzian spiritual health questionnaire and Meraviglia prayer questionnaire. The data were analyzed using SPSS 20 with descriptive parameters (mean and standard deviation) and Pearson correlation coefficient, t-test and 1-way ANOVA. 
Results Of 142 patients, 64 (45.1%) were men and 78(54.9%) were women. The mean age of the elderly  was 72.97±7.67 years with the range of 60-95 years. The mean of total prayer scores was 181.62±25.50 and the highest score of prayer was related to prayer frequency with the mean of 96.47±22.3. The mean of total spiritual health scores was high (102.28±18.89), too. The relationship between prayer and spiritual health was direct and significant (P<0.001, r=0.602). There was significant relationship between age and spiritual health, too (P<0.001, r=0.607). There was no significant relationship between spiritual health and education level, job, and the marital status.
Conclusion Religious practice and prayer can be a powerful resource for coping with stressful situations and psycho-social support in patients with stroke.