Background: Stroke can greatly impact both physical capabilities and overall quality of life (An and Shaughnessy, 2011, Bártlová et al., 2022). While the 2019 novel Coronavirus (COVID-19) significantly impacted various sectors including access to healthcare services, access to routine stroke rehabilitation were not well documented in referral hospitals of Lusaka. Objectives: To assess factors affecting routine rehabilitation of stroke survivors during COVID-19 in referral hospital settings of Lusaka. Method: This was a cross-sectional study involving 26 stroke survivors who were present before and during the COVID-19 pandemic lockdown. All respondents were from 5 referral hospitals in Lusaka. Data was collected using researcher-administered structured questionnaires and analyzed using SPSS v27.0. Bivariate analysis was carried out using chi-squared and Fishers exact test of association. Results: There was an overall higher stroke patient response rate from females (57.7%, n=15) than males (42.3%, n=11). The outcome variable was significantly associated with only two intrinsic factors namely fear (mean rank of 1.69) seconded by patients’ perception of physiotherapist’s attitude (mean rank of 2.50). An overall decline in physiotherapy attendance from 2-3 times a week (69.2%, n=18) to once in a week (54%, n=14) was observed. Conclusion: A notable shift inclination towards home-based rehabilitation raises important considerations for healthcare practitioners and policymakers. It prompts a critical examination of the potential consequences of this shift on the quality and effectiveness of rehabilitation. Clinical implications: The identified barriers, particularly fear, highlight the need for targeted interventions. The study serves as a reminder of the complexities inherent in balancing patient needs, safety considerations, and healthcare system capacities.