Objective To construct a transitional care model for downward referral of stroke patients in regional medical alliance, so as to meet transitional care needs of stroke patients. Methods Based on the transitional care model and population-capacity-process framework, literature review, qualitative interview, and Delphi expert consensus method were used to develop the transitional care model of downward referral of stroke patients in regional medical alliance.Eighteen experts were invited to participate in a two-round consultation. Results The response rate of the experts was 100% in round 1 and 94.4% in round 2.The expert authority coefficients were 0.867 and 0.868, respectively.The Kendall′s coefficients of concordance (W) were 0.118 and 0.267, respectively （both P＜0.05）.The coefficient of variation for each item ranged from 0 to 0.204 in round 2.The final version of the transitional care model for downward referral of stroke patients in regional medical alliance included 5 dimensions, namely implementing agencies, staffing, key procedure, implementing paths, and effect evaluation, totaling 23 primary items and 60 secondary items. Conclusion This innovative transitional care model for downward referral of stroke patients in regional medical alliance is comprehensive, rigorous and normative, which will enable medical staff to provide transitional care for stroke patients in different institutions.