AbstractAcute ischemic stroke is one of the leading causes of death and disability worldwide. The ultimate goal in treatment of acute ischemic stroke is to achieve revascularization in time to prevent irreversible damage to the brain tissue, without increasing the risk of symptomatic intracranial hemorrhage. During the paste decade new therapies using an endovascular approach have evolved. The aim of this presentation is to describe the experience with endovascular treatment, such as the Penumbra system, the MERCI retriever, the Snare, angioplasty and stenting, used as single therapy or in combination with administration of intravenous and/or intra-arterial thrombolytics in patients with acute ischemic stroke. Early reperfusion is the most important predictor of good functional outcome. Decisions about treatment are based upon baseline clinical data, time from onset to treatment, identification of early signs of infarction on brain imaging with CT/ MRI, and presence of arterial occlusion and collateral flow on angiography. Endovascular treatment is efficient and favourable in specially selected patients. Review of the current literature reveil a need of further investigation and randomized controlled trials.