Acute stroke is the second most common cause of death following heart diseases. Stroke is secondary to no or poor blood supply to brain due to occlusion of a blood vessel by a clog (acute ischemic stroke) or perforation of blood vessel (acute hemorrhagic stroke). The most important point is to eliminate occlusion without unnecessary loss of time, especially in treatment of acute ischemic stroke (secondary to occlusion by a blood clot). Patients or family members should call ambulance service, if acute stroke is suspected, and patient should visit or be brought to a hospital immediately. If the patient is assessed by a neurologist and stroke is confirmed, cranial tomography should be scanned first in order to rule out cerebral hemorrhage. When hemorrhage is not present, treatment should be planned without wasting any time in order to eliminate the blood clot. Intravenous thrombolytic agent should be administered if less than 4,5 hours have elapsed since the onset of stroke. Patients should be immediately referred to stroke centers, irrespective of thrombolytic therapy. Mechanical thrombectomy should be performed with angiographic technique within the first 6 hours after patients are admitted to stroke centers. This method is very critical to minimize the damage to brain secondary to stroke. Angiographic removal of blood clot can be considered in selected patients up to 24 hours after stroke.