Aim: We investigated the prevalence of seizures in term‐born infants with a perinatal stroke in Swedish neonatal wards, assessed the anti‐seizure medication prescribed and determined the accuracy of diagnostic codes. Methods: This cross‐sectional study used data from the Swedish Neonatal Quality Register. The cases were infants born at ≥37 weeks in 2009–2018 and admitted to a neonatal ward in Stockholm County with a stroke diagnosis, confirmed by their medical chart. The controls were all Swedish infants born during those years. Results: There were 76 infants with a confirmed perinatal stroke: 51 ischaemic and 25 haemorrhagic. Seizures were documented in 66/76 (87%) of infants with a stroke and 0.2% of the controls. Anti‐seizure medication was administered to 64/66 (97%) infants with a stroke and seizures. In 60 cases, the drugs administered were specified, with phenobarbital used in 59/60 cases (98%). More than one drug was administered to 25/60 (42%) infants and 31/60 (52%) were discharged with anti‐seizure medication. The positive predictive value for the stroke diagnostic codes was 80.5% (95% CI 76.5–84.5). Conclusion: Seizures were common in infants with a perinatal stroke. More than one anti‐seizure drug was often required and many infants were on anti‐seizure medication at discharge, against Swedish recommendations. [ABSTRACT FROM AUTHOR]