In February 2006, he suffered a stroke in Scarborough, and stated: "I hope to be back on my feet, or should I say my left leg, as soon as possible, but I know it is going to take some time. In the meantime I am in excellent hands and so is the Stephen Joseph Theatre." He left hospital after eight weeks and returned to directing after six months, but the following year he announced he would step down as artistic director of the Stephen Joseph Theatre. Ayckbourn, however, continues to write and direct his own work at the theatre.
Although Ayckbourn's plays no longer dominate the theatrical scene on the scale of his earlier works, he continues to write, his most recent major success being Private Fears in Public Places that had a hugely successful Off-Broadway run at 59E59 Theaters, and in 2006 was made into a film Cœurs, directed by Alain Resnais. After suffering a stroke, there was uncertainty as to whether he could continue to write (the Ayckbourn play premiered immediately after the stroke, If I Were You, was written before his illness), but his first play written afterwards, Life and Beth, was premiered in the summer of 2008. Ayckbourn continues to write for the Stephen Joseph Theatre on invitation of his successor as artistic director, Chris Monks, with the first new play under this arrangement, My Wonderful Day, performed in October 2009. His play Roundelay opened in September 2014; the order in which each of the five acts is played in each performance is to be left to chance (allowing 120 possible permutations), with members of the audience being invited to extract five coloured ping pong balls from a bag beforehand.
After Ayckbourn suffered a stroke in February 2006, he returned to work in September and premiered his 70th play If I Were You at the Stephen Joseph Theatre the following month.