AbstractThis study aimed to explore the relationship between intrusive and deliberate rumination, to identify distinct trajectories of intrusive and deliberate rumination, and to examine their predictors in young and middle‐aged stroke survivors. This study employed a longitudinal design in which 200 young and middle‐aged stroke survivors were investigated at 1‐week pre‐discharge (T0), 1 month (T1), 3 months (T2), and 6 months (T3) post‐discharge. The Event‐Related Rumination Inventory, Simplified Coping Style Questionnaire, and Perceived Social Support Scale were used for data collection. The results showed that intrusive rumination was positively correlated with deliberate rumination at T0 and T1, and negatively correlated with deliberate rumination at T3. Growth mixture modeling identified three classes of intrusive rumination: Stable‐low, Declined, and Elevated group, and two classes of deliberate rumination: High‐level and Low‐level group. Furthermore, number of children or dysfunctions, type of stroke, family history of stroke, negative coping, and social support were found to predict intrusive rumination. These findings can help healthcare providers timely intervene on survivors in the Elevated and Stable‐low intrusive rumination groups, and the Low‐level deliberate rumination group.