Background: Balance disorder is a prevalent clinical manifestation following stroke, often causing considerable discomfort and gait disability. Various water-based therapeutic approaches have been developed to address balance and gait disorder. Objects: The purpose of this study was to investigate the effects of water-based gait training using auditory stimulation on balance and gait abilities in stroke patients. Methods: All subjects were randomly divided into three groups: water-based gait training using auditory stimulation group (WAG) (n = 24), water-based gait training group (WG) (n = 24), and control group (n = 22). Subjects in WAG and WG underwent water-based gait training for 30 minutes, 3 times a week for 6 weeks. All Subjects were assessed for muscle strength, balance, gait, motor function, and activity of daily living pre- and post-intervention. Results: Results showed that all outcome measures significantly improved post-intervention (p < 0.05). Additionally, WAG was found to significantly improve in Medical Research Council (MRC), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test compared to WG, and WG showed significant differences compared to the control group in MRC and Fugl-Meyer Assessment (FMA) (p < 0.05). WAG exhibited significant differences in all areas except Modified Bathel Index (MBI) in the between-group comparison with the control group (p < 0.05). Conclusion: These results suggest that water-based gait training using auditory stimulation may be effective strategy to improve muscle strength, balance and gait ability for with stroke.