The aim of this study was to evaluate the efficacy and safety of VR-based telerehabilitation in improving fine motor skills in stroke survivors. The aim was to evaluate the impact of a VR intervention on manual dexterity, accuracy, and coordination. Stroke survivors often experience impairments in fine motor control. This is due to damage to the motor paths of the brain. Traditional rehabilitation methods have limitations, and new approaches such as VR telerehabilitation offer potential benefits. VR provides a virtual environment that engages patients and promotes repeat practice. Which promotes the flexibility of the nervous system Conduct a systematic search of relevant databases. Extract data Quality assessment and meta-analysis. The review found that telerehabilitation using VR significantly improved fine motor skills in stroke survivors. The VR intervention improved hand strength, accuracy and coordination. Patient satisfaction and consistency are generally high. Safety data is good with minimal reported side effects VR-based telerehabilitation is considered an effective tool for restoring fine motor skills in stroke survivors. Future research should explore appropriate methodologies.