Purpose / Context - The aim of this study was to determine whether the quality of the indoor ther-mal environment during winter could increase the risk of cerebrovascular disease. Methodology / Approach - An epidemiological survey of approximately 200 elderly persons living in a cold climatic region of Japan was conducted. The survey was divided into three phases, and the investigated areas were three rural towns with different rates of death due to cerebrovascular disease. Results – Results indicate that feeling a draft in the living room while operating heating equipment and the style of bathtub were positively associated with an increased rate of death due to cerebro-vascular disease. The bathroom with a traditional type bathtub tends to be cold, and its indoor thermal environment during winter is poor. Key Findings / Implications – Poor quality of the indoor environment during winter could increase the risk of cerebrovascular disease. Originality – The fidings of this study will contribute to accumulate the knowledges showing the associations between indoor thermal environment and health.