Stroke is a syndrome characterized by a sudden neurological deficit caused by intracranial hemorrhage or ischemia. Computed tomography (CT) maintains a primary role in the evaluation of patients with acute stroke. The optimal magnetic resonance imaging (MRI) protocol in acute stroke includes diffusion-weighted imaging (DWI) to show acute ischemic lesion and MR perfusion study to estimate brain perfusion. Careful selection of patients for a thrombolytic therapy is crucial to improve safety and efficacy.