Background. Stroke remains a leading cause of mortality and disability. Telemedicine is an effective tool to improve access to specialized care. However, the experience of implementing centralized telemedicine consulting networks at the regional level requires generalization. Objective. To summarize the experience of organizing the Stroke Monitoring Center (SMC) in the Republic of Bashkortostan and to analyze its performance in 2025. Material and methods. A retrospective descriptive study of the SMC, established within the Regional Stroke Center (RSC) of the Emergency Clinical Hospital in Ufa, was conducted. Data for 2025 were analyzed, including the number of requests, nosological structure, volume and types of consultations, and financial indicators. Results. In 2025, the SMC received 1,254 requests. Ischemic stroke was confirmed in 67.8% (n=850) of cases, and hemorrhagic stroke in 28.5% (n=358). A total of 1,139 computed tomography reports and interpretations were performed (including 575 with contrast), along with 145 neurosurgery consultations, 67 consultations on endovascular diagnostics and treatment, 32 cardiovascular surgery consultations, and 14 neurology consultations. The SMC services were used by 19 medical organizations. The total funding under contracts amounted to 827.5 thousand rubles. The highest activity was observed from the Beloretsk Central District Clinical Hospital (37%), the Oktyabrsky City Hospital (25%), and the Dyurtyuli Central District Hospital (21%). Ischemic stroke predominated in the request structure (67.8%). Based on the consultation results, decisions were made regarding reperfusion therapy, thrombectomy, neurosurgical interventions, and patient routing. Conclusion. Establishing an SMC within a regional stroke center enables 24/7 remote support for primary stroke units, reduces decision-making time, improves access to specialized care, and optimizes patient routing for acute stroke in the region. The presented experience may be useful for creating similar centers in other constituent entities of the Russian Federation.