Stroke and transient ischemic attack (TIA) share similar risk factors and methods of evaluation and secondary prevention. As neurological symptoms resolve after TIA, however, there has been a widely held perception that urgent evaluation and treatment following TIA are unnecessary. In actual fact, it is becoming increasingly clear that the short-term stroke risk after TIA is very high. Recent studies have identified independent predictors that indicate which patients are at highest risk of recurrent ischemic events. These risk scores could enable physicians to target appropriate patients for urgent care. In this Review, we summarize the recent literature on stroke risk after TIA and risk stratification, and recently published guidelines on evaluation and treatment.