Objective To investigate the status of self-perceived burden in the elderly with acute stroke and analyze its effect on self-management behaviors in 1 month after stroke. Methods A questionnaire survey was performed among 216 elderly inpatients with stroke from 3 upper first-class hospitals in Xi′an during January and September 2017, including general data questionnaire, self-perceived burden scale, and stroke self-management behavior rating scale. Finally, 209 valid questionnaires were collected, and the correlation between self-perceived burden at the acute phase and self-management behavior at recovery phase was analyzed by Spearman correlation analysis with SPSS statistics 23.0. Results Among the 209 elderly stroke patients, 98.56% (206/209) of them had a self-perceived burden in the acute phase of the disease, and 75.60% (158/209) had moderate and severe self-perceived burden. The total score of self-management behavior and the scores of its 2 dimensions of emotion and social function and interpersonal management were negatively correlated with the total score of self-perceived burden in the acute phase in the patients (r=-0.190,-0.422, -0.270; P<0.05). And the total score was weakly negatively correlated with the emotional and economic self-perceived burden scores in the acute phase (r=-0.175, -0.203; P<0.05), and the emotional management dimension had the greatest correlation with the self-perceived burden and its 3 dimensions in the acute phase (r=-0.422, -0.214, -0.457, -0.328; P<0.01). Conclusion The elderly patients with acute stroke generally have moderate or severe self-perceived burden during the acute phase. It interacts with self-management behaviors in the early stage of rehabilitation. The stronger the self-perception burden is, the worse the self-management behaviors are. Medical staffs and patients′ relatives and friends should strengthen psychological counseling in the acute phase, instruct the patients to actively carry out rehabilitation exercise in the early stage of rehabilitation, do a good job in self-management of disease and daily life, promote rehabilitation and improve the quality of life.