Multimodal neuroimaging is assuming an increasingly important role in the initial evaluation and management of acute stroke patients in parallel with the expansion of therapeutic options. Multimodal MRI can identify the type of stroke (ischemia or hemorrhage), severity and location of the lesion, the patency of the intracranial vessels, the degree of cerebral perfusion, and the presence and size of the ischemic penumbra. This information can be used to guide both acute and long-term treatment decisions for stroke patients.