Objective To examine whether Six Sigma management improve early rehabilitation exercise compliance in stroke patients. Methods Totally, 86 stroke patients from March to June 2018 were recruited as the control group, for whom, the charge nurses conducted early exercise assessment, developed and implemented rehabilitation plans, and evaluated the effect. Another 86 cases from August to December 2018 were assigned into an intervention group, and subjected to Six Sigma management: the Six Sigma management team found out the reasons for the low exercise compliance of stroke patients in early stage, and made individualized early exercise plan. Early exercise compliance was compared between the two groups. Results The intervention group had better early exercise compliance than the controls (P＜0.01). Conclusion Six Sigma management could effectively improve the compliance of early exercise in stroke patients.