This study aims to explore the impact of improved cook stoves (ICS) on fuel expenditure (consumption), smoke emission, and health of women (cook) in rural households of Bangladesh. In the follow-up survey (January-March 2010), 1,569 households, constituting of both who received ICS immediately after baseline survey (July-September 2008) and who had refused to use any ICS, were selected for interview using a pre-tested structured questionnaire. The most convincing evidence showed lower fuel expenditure (>60% respondents reported), cooking time (45%), or time spent in collecting fuel for ICS compared to traditional stove. The respondents reported that smoke emission reduced (86.4%) and soot production dropped (89%) due to using ICS. This indicates the importance and potentials of ICS in reducing indoor air pollution and hence less exposure and lower effect on health. We found that 63% of the respondents did not go anywhere for treatment on health problems mainly respiratory illness symptoms such as sore throat and coughs (>90% respondents reported), or eye irritation, difficulty in breathing, night sweats, headache (>75% respondents reported) within 30 days since the interview was done. However, impediments still remained to see clear benefit of ICS by the users such as on technological aspects like design and maintenance of ICS, awareness rising (in terms of importance of ICS) and provision of interim monitoring whether ICS will work well or need supports. ICS intervention was successful in reducing fuel consumption expenditure, time spent in collecting fuel and cooking food, and reducing smoke emission and health hazards. Thus, it is necessary to pay more attention to these impediments to further improve the existing situation.