For subacute stroke care, teleneurological ward rounds were found to be not only noninferior but clearly superior to conventional on‑site rounds, achieving guideline adherence in 92% of cases compared with 54% for in‑person care. This finding came from a prospective, multicenter, nonrandomized noninferiority study conducted across 15 primary care hospitals in four German telestroke networks between October 2022 and December 2024. In the study, adults hospitalized with suspected ischemic stroke, hemorrhagic stroke, or transient ischemic attack received both a teleneurological and an on‑site neurological ward round. Blinded external neurovascular experts evaluated documentation from each consultation, focusing on complete fulfillment of six predefined guideline‑based quality domains: etiological classification, neurological examination, risk assessment, diagnostic recommendations, secondary prevention, and recommended aftercare. Among 501 patients (median age, 71 years; 44% female), telestroke rounds met all of the quality criteria in 92% (95% CI, 90%–94%) versus 54% (95% CI, 49%–58%) for on‑site rounds, an absolute difference of 38 percentage points. The largest advantage was seen with secondary prevention, which had a 21‑point difference between teleneurological and on‑site neurological ward rounds.