Background: Stroke has been considered the second leading cause of death worldwide, affecting around 13.7 million people and causing an annual death rate of 5.5 million worldwide. It is a neurological disorder causing impairments in social and occupational functioning, reducing the quality of life for patients. Patients with stroke often experience a range of psychological and behavioral challenges, including negative illness perception and poor mental health status, which can affect the levels of self-care behaviors. Coping style can mediate the relationship between the mentioned factors. Hence, understanding the mediation role of coping style and how illness perception and mental health status influence self-care behaviors can provide insights into effective interventions . Purpose: This study aimed to investigate the relationship between illness perception, depression, coping strategies, and self-care management behaviors among patients with stroke in Saudi Arabia, and to test the mediation effect of coping styles in the relationship between illness perception and depression and self-care management behaviors. Methods: This study used a cross-sectional descriptive design to answer the study related questions. Participants of the study were Saudi adult patients who had been diagnosed with stroke six months prior to conducting this study. Data was collected using a self-administered questionnaires including Demographic and Clinical Characteristics, Brief Illness Perception Questionnaire (BIPQ), Patients Health Questionnaire-9 (PHQ-9), Stroke Self-Management Behaviors Performance Scale (SSBPS), and Brief Coping Inventory (brief COPE). Results: Out of 500 participants, (72.6%) were married; (54.2%) were females and had experienced an ischemic stroke (84.6%). The mean illness perception score among the study participants was 45.82 (SD= 8.34), indicating a significant issue. PHQ-9 had a mean score of 17.256 (SD= 4.12) indicating a high level of depression. Maladaptive coping strategies had an average score of 19.45 (SD= 2.96), on the other hand, adaptive strategies (M±SD) had a much higher mean score (M= 43.62, SD= 5.639). The mean and standard deviation of Self-care behaviors were (40.92±10.73), suggesting acceptable levels of self-management practices. The study found significant positive correlations between illness perception, depression with self-care behaviors (r = 0.07, 0.064, respectively, p < 0.01). A significant negative correlation was observed between maladaptive coping style and self-care behaviors (r = -0.048, p < 0.01). Depression has a negative correlation with illness perception, maladaptive coping, and adaptive coping styles (r = -0.05, -0.718, -0.129, respectively, at a p value level of < 0.01). Illness perception had a positive correlation with maladaptive coping styles (r = 0.048, p < 0.01) and a negative correlation with adaptive coping (r = -0.033, p < 0.01). Path analysis suggested that coping style has mediated the effect of illness perception and depression on self-care behaviors with a statistically significant mediation effect (Z score = 3.42, p = 0.0006, p < 0.05). Conclusion: The study emphasized the need for implementing interventions to effectively counteract the psychological impact of stroke and reduce the occurrence of depression among stroke patients. Employing early multidisciplinary therapeutic approaches to foster positive illness perception, reduce the burden of depressive symptoms, and facilitate adaptive coping styles leads to better adherence to self-care management plans among patients with stroke. Healthcare providers, along with the health care policymakers, are invited to use these results in tailoring individualized health care plans for patients with stroke.