Objective: To describe the acute care of patients with bilateral thalamic infarctions in primary and advanced stroke centers in different regions of Colombia.Methods: Multicenter retrospective descriptive study of a series of cases of patients with an imaging diagnosis of bilateral thalamic infarction, in Colombia.14 hospitals located in seven cities of the country participated.Results: 28 cases were registered, the mean age was 66.8 years with 53.6% men and 96.3% had a favorable previous mRs (0-2).Mean NIHSS at admission was 14 points, the most frequent clinical presentation was altered mental status in 82.1%.The most compromised structure was the bilateral anterior region of the thalamus in 12 patients (42.85%).The most common etiology was undetermined cause (39.3%). 1 patient underwent reperfusion therapy with intravenous thrombolysis (3.6%).Mean hospital stay was 19 days.Conclusions: Bilateral thalamic infarcts are a diagnostic challenge in the emergency department, due to their low reported incidence and the variable clinical presentations, stroke and research centers should be strengthened to contribute to clinical outcomes.