Purpose: To examine the ecological validity, predictive validity, and responsiveness of the Five Digit Test (FDT) in patients with stroke. Methods: We included inpatients with stroke (n = 144, 114 and 105 in the ecological validity, predictive validity, and responsiveness analysis, respectively) in the study. At admission, the FDT and Barthel Index (BI) were assessed; at discharge, the FDT, BI, Postural Assessment Scale for Stroke Patients (PASS), and Mobility Subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) were assessed. Results: In the ecological validity analysis, the scores of the selective and alternating attention indices of the FDT were moderately correlated with those of the BI at admission and discharge (Spearman rho = -0.38 to -0.45). In the predictive validity analysis, the scores of the two attention indices of the FDT at admission were moderately correlated with the scores of the BI, PASS, and MO-STREAM at discharge (rho = -0.33 to -0.45). In the responsiveness analysis, the two attention indices of the FDT between admission and discharge had large differences (success rate difference = 0.56-0.67, Wilcoxon Z = -5.90 to -6.60). Conclusion: Our results indicate that the selective and alternating attention indices of the FDT have acceptable ecological validity, predictive validity, and good responsiveness in patients with stroke.