Purpose This study investigated the effects of taskoriented aquatic gait training with differential loading on muscle strength, balance, and gait in patients with chronic stroke. Methods Twentytwo patients with stroke were randomly assigned to an experimental group or a control group. The experimental group received aquatic gait training with differential loading, while the control group performed general aquatic gait training. Both interventions were conducted for 30 minutes per session, three times per week for six weeks. Muscle strength, balance, and gait were assessed before and after the intervention. Results After the intervention, significant improvements in muscle strength, balance, and gait were observed in the experimental group compared to the control group. Significant increases in lower extremity muscle strength were identified in the paretic hip flexors, hip extensors, hip abductors, knee flexors, knee extensors, ankle dorsiflexors, and ankle plantar flexors, as well as in the nonparetic hip flexors, hip extensors, knee flexors, and ankle dorsiflexors (p<.05). Significant improvements in balance and gait were also found in the Berg Balance Scale scores, limits of stability, plantar pressure distribution symmetry, gait speed, cadence, and mean stride length (p<.05). Conclusion Aquatic gait training with differential loading was effective in enhancing muscle strength, balance, and gait performance by improving body symmetry in patients with stroke.