Ischemic stroke is the leading cause of disability and the third death in modern society. The end result after a stroke depends on the speed and quality of treatment, starting at implementing strategies to reduce the delay, both extra- and intra-hospital, in health care. Assistance includes patient stabilization, with special attention to the maintenance of the airway, and the management of blood pressure and heart rate. The initial assessment should be quick and be focused on the differential diagnosis, the estimating of the size and location of the infarction, as well as consideration of therapies. Among them, the only currently approved is thrombolysis with intravenous recombinant tissue plasminogen activator or blood in selected patients with a clinical course of less than three hours.