Stroke is defined by the World Health Organization as a clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin. Stroke is classified broadly into three categories such as ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage. Approximately 60–80% of all strokes is ischemic and is more common in cardiovascular patients as well. This chapter reviews the acute ischemic strokes and their endovascular management. Clinical presentation of stroke depends on the area of the brain affected by occlusion of the arteries. To achieve a good functional outcome, there is a huge need for a well-regulated stroke team headed by an endovascular stroke specialist that can deliver good care expeditiously.