The aim of this study was to determine the association between the daily number of cases of ischemic stroke (IS) and hemorrhagic stroke (HS) in patients aged 25-64 years and the El Nino-Southern Oscillation (ENSO) events during 2000-2015. As an indicator of the effect of the ENSO, the monthly NINO 3.4 index (Equatorial Pacific Sea Surface Temperature) was used. During the 5844-day study period, 5600 cases of stroke (3170 (56.61%) in men and 2430 (43.39%) in women) were analyzed. Of these, 4354 (77.8%) cases were IS, and 1041 (18.6%) cases were HS. In 3496 (62.2%) cases, stroke occurred in the age group of 55-64 years. In the analysis, we used the following categories of the ENSO events: strong La Nina, moderate La Nina, moderate El Nino, and strong El Nino. The effect of the ENSO was examined by using the multivariate Poisson regression adjusting for weather variables. The highest risk of both strokes (BS) was observed on days of strong and moderate La Nina (rate ratio (RR) 1.27, 95% CI 1.13-1.42) and RR = 1.15 (1.07-1.23), respectively), while the risk for IS was the highest on days of moderate El Nino (RR = 1.11(1.02-1.20)). A lower risk for BS was found on days of strong El Nino (RR = 0.77(0.62-0.97)). We found that ENSO events affected the occurrence of BS and IS in all age groups, and the strongest effect was observed among females. The results of this study provide new evidence that ENSO events may affect the risk of stroke, especially the risk of IS.