Stroke, which is a leading cause of disability, is presumed to affect hearing by impacting the auditory pathways or hearing organs, influencing communication and socialization. We analyzed data from the National Health Interview Survey (NHIS) from 2015–2018, including 118,625 individuals. Hearing function and activity limitations were evaluated by self-reported measures. Various statistical tests and regression analyses were used to compare and investigate the data between the different groups. Stroke patients had a higher prevalence of hearing dysfunction, with 23.8% reporting excellent hearing versus 46.9% among non-stroke individuals (P < 0.001). Additionally, stroke patients exhibited higher rates of little trouble hearing (19.9% vs. 10.9%), moderate trouble hearing (10.5% vs. 4.2%), much trouble hearing (8.7% vs. 2.2%), and deafness (0.8% vs. 0.3%) when compared to non-stroke subjects (P < 0.001 for all). Several factors were identified as significant contributors to hearing impairment among stroke patients, including male gender (OR = 1.58; 95% CI, 1.39–1.8; P < 0.001), diabetes (OR = 1.2; 95% CI, 1.04–1.38; P = 0.01), smoking (OR = 1.44; 95% CI, 1.2–1.73; P < 0.001), and sinusitis (OR = 1.45; 95% CI, 1.23–1.7; P <0.001). Stroke among subjects with hearing impairment was strongly related to limitation in leisure and social activities (OR = 2.5; 95% CI, 2.30–2.84). Our study demonstrates significantly higher rates of hearing impairment among stroke patients compared to non-stroke individuals, which adversely impacts their participation in leisure and social activities.