ecent data reveal a significant increase in strokeassociated morbidity globally, driven by low-and middle-income countries (LMICs). 1,2Therefore, substantial concerted efforts in these countries are needed to address the World Health Organization's sustainable goals for reducing the burden of non-communicable disorders.Despite recent advancements, there is a significant lag in stroke awareness, access to stroke care, and infrastructure in LMICs compared with high-income countries. 1Shortages in resources, expertise, and well-trained personnel, as well as socioeconomic, cultural, and geographic circumstances, further compound the obstacles to optimal stroke care. 3Delivery and equity in stroke treatment remain unattainable goals at the moment.This brief narrative describes the individual and collective perspectives of junior stroke faculty physicians serving in areas geographically dispersed across the globe, with significantly disparate stroke burden, health care needs, infrastructure, and expertise.It highlights the importance and potential impact of cross-country collaboration, pooling of resources, and leveraging expertise to improve stroke care in areas with increased needs but low availability across and beyond borders. STATING THE PROBLEM: CHALLENGES AND BARRIERS TO STROKE CARESignificant differences exist in stroke care delivery, with each region confronting its unique challenges. 4The Table summarizes the marked differences in stroke care delivery according to the authors' country of practice.Individual country circumstances in education, economic potential, fiscal constraints, available healthcare funding, and health policies dictate the need for pragmatic modifications and adaptations of healthcare systems to accommodate the realities in LMICs.Current stroke treatment models are based on evidence derived from high-income countries settings, many of which are not feasible in LMICs.For example, landmark trials have established reperfusion therapies like intravenous r-tPA (recombinant tissue-type plasminogen activator) and mechanical thrombectomy as the standard of care for acute ischemic stroke.However, significant barriers to their implementation remain in many countries.In a global survey, we found that hospitals in high-income countries are significantly more likely to offer access to r-tPA compared to LMICs.The cost of r-tPA was found to be prohibitively high in LMICs, equal to 652.6% of the per capita health expenditure, compared to 20.8% in high-income countries, 7 highlighting cost and affordability as a vital, although not singular, barrier.Similarly, despite the well-known benefits of mechanical thrombectomy, 8 the procedure is widely available almost exclusively in North America, Europe, Japan, and Australia, remaining inaccessible to a large part of the world population. 9Fiscal considerations may impact health allocation resources in LMICs and the incorporation of high-cost treatment strategies.