Background and purpose: Very early mobilization (VEM), defined as out-of-bed activity within 24 hours after stroke onset, is considered an important part of the rehabilitation after acute stroke in many stroke units. However, there is today little evidence of the effect of this treatment compared to standard care (SC). The aim of this literature study is to summarize the results of randomized controlled trials that have investigated this topic. Methods: I have searched PubMed for relevant literature published the last ten years by combining the terms 24 hours , 24 hour , 24 h , early ambulation , early mobilization , physical therapy , physiotherapy , rehabilitation and stroke . Results: Only the results from one of the trials have shown that very early mobilization gives better outcome than standard treatment. However, there are trends towards an association between VEM and good outcome. There were no significant differences in complications, poor outcome and death between the VEM- and the SC-patients. The main limitation of the studies is the small sample sizes. Conclusion: The trials have not found evidence of harmful effects of VEM. Hence, VEM appears to be safe and feasible. To be able to conclude about any possible positive effects of the intervention, the topic needs to be further investigated in larger randomized, controlled trials. One such study is currently in progress.