Background: Home BP telemonitoring, with pharmacist case management, leads to clinically important BP reductions. Our objective was to determine the incremental cost-effectiveness of this intervention compared with usual care BP control in patients with cerebrovascular disease in Alberta, Canada. Methods: A cost-utility analysis using a Markov decision model was created, examining a cohort of high-risk patients with a recent cerebrovascular event residing in their own residence. A lifetime time horizon and health care payer perspective was used. Achieved BP and risk of future cardiovascular events (recurrent stroke, myocardial infarction, unstable angina, or death) were modelled, with attendant consequences on quality adjusted life years and costs. BP telemonitoring was assumed to occur monthly until BP was controlled, then quarterly. Canadian life tables were used to determine overall mortality, adjusted by CVD mortality. Relative efficacy on intervention-associated BP lowering were obtained from published data. Reduction in BP of 9.7/5.1 mmHg at 12-months was used in the base case. Resource use and costs were obtained from Canadian published literature. Results: Telemonitoring with case management led to net health care savings of $2326, and an additional 0.83 QALYs (see Table). Results were robust in sensitivity analysis (see Table). Conclusion: Home BP telemonitoring and pharmacist case management was a dominant strategy, as it lowered costs and improved QALYs, and should be implemented.