Background and purpose:  The incidence of ischaemic stroke has increased or remained high in China; however, little population‐based evidence is available on the incidence and survival of lacunar infarction (LAC). We examined the incidence of LAC in a northern Chinese (Beijing) population and monitored survival. Methods:  A prospective registry population‐based study was conducted over a 6‐year period in a general, unselected, and representative community in Beijing with approximately 100 000 long‐term permanent residents. All first‐ever stroke cases were registered. Results:  A total of 1184 patients with ischaemic stroke were identified; 36.9% (437 cases) were classified as LAC. Age‐standardized incidence rates of LAC ranged from 24.0 to 51.3/100 000 with an average rate of 35.3/100 000 during study period. The incidence of LAC increased with age before 70 years. The incidence of non‐LAC increased with age. There were no significant differences in crude incidence of LAC between men and women (78.4/100 000 vs. 75.4/100 000). The incidence of non‐LAC was significantly higher in men than in women (155/100 000 vs. 107/100 000, P < 0.001). The 28‐day case fatality proportions were significantly lower in patients with LAC (0.5%) versus non‐LAC (14.9%). One year after acute stroke onset, the survival rates between LAC and non‐LAC were similar. Conclusion:  LAC is a common stroke subtype in Northern China. Men or the elderly are more likely to have non‐LAC. Long‐term survival following LAC is similar to non‐LAC patients. Click here to view the accompanying paper in this issue.