Objective To clarify the specific process and development of post-traumatic growth in young and middle-aged stroke patients, and to provide evidence for psychological intervention in different post-stroke stages. Methods Using purposive sampling method, 12 young and middle-aged stroke patients were selected to conduct in-depth face-to-face semi-structured interviews at 3 time points (one day before discharge, 3 months and 6 months after discharge). The interview data were analyzed by using Strauss and Corbin′s grounded theory. Results There were three different stages in the post-traumatic growth trajectory, namely, destruction and stress, reconstruction and hardship, and integration of growth. However, these three stages weren′t a linear process, but in dynamic evolution. There were three types of post-traumatic growth trajectory: continuous stress, gradual growth, and growth decline. Conclusion Post-traumatic growth in young and middle-aged stroke patients showed a 3-stage non-linear progressive trajectory which could be summarized into 3 types. Medical staff can provide psychological intervention contingent on the feature of patients′ post-traumatic growth trajectory.