PURPOSE: The demand for stroke rehabilitation is rising across Low- and Middle-Income Countries (LMICs). This review explores the determinants affecting access to and utilization of post-stroke physical rehabilitation in LMICs. MATERIAL AND METHODS: A systematic literature search across multiple databases retrieved 463 articles, of which 35 studies included were from Asia, Africa, and South America met the inclusion criteria. During the review process, 2 additional relevant studies were identified and added. A descriptive synthesis was conducted to identify key determinants influencing rehabilitation access and use. RESULTS: Three major categories of determinants emerged: (1) Contextual factors, including traditional/spiritual beliefs, reliance on alternative medicine, gender disparities, poor awareness, and environmental barriers
(2) Personal factors, such as apathy toward rehabilitation, lack of clinical guidance, and psychological challenges (fatigue, depression, cognitive impairment)
(3) Resource-related factors, including high out-of-pocket costs, low provider pay, insufficient infrastructure, inadequate health policies, limited professional training, and poor rehabilitation curricula. Recommendations focus on capacity building, service delivery, extended support, and treatment content. CONCLUSION: LMICs face unique, context-specific challenges in stroke rehabilitation, requiring tailored solutions. Addressing these barriers necessitates region-specific strategies that align with health system structures, governmental policies, economic resources, professional education, and clinical practice guidance.