Maryland’s statewide regional system approach to stroke care continues to evolve with the publication of new research findings on stroke care. In FY 2023, the Stroke Quality Improvement Committee (Stroke QIC), consisting of Maryland 14 hospitals’ stroke program coordinators and stroke program medical directors, focused on ongoing initiatives for improving stroke care in Maryland. Following the promulgated and enacted revision and updates to the COMAR regulations for Primary Stroke Center (PSC) and Comprehensive Stroke Center (CSC) in FY 2022, two additional stroke center designations were promulgated and enacted for the improvement of the regional system of care approach. The two types of center designations are the Acute Stroke Ready Hospital Center (ASRHC) and the Thrombectomy-Capable Primary Stroke Center (TCPSC). All stroke centers maintain their designations for up to five years. In FY 2023, two PSCs achieved an initial designation as a TCPSC, and six PSCs designations were renewed. Currently, Maryland has designated 32 Primary Stroke Centers, three Comprehensive Stroke Centers, and four Thrombectomy-Capable Primary Stroke Centers.