A transient ischaemic attack (TIA) is defined as a stroke that recovers completely within 24 hours of onset. TIA and stroke are the same disease and both need to be treated with equal urgency. Patients with ongoing symptoms and signs at the time of assessment, however early after onset and even if improving, need to be treated as stroke with rapid transfer to an inpatient stroke service. The assessment of TIA requires taking a careful history to determine the onset of symptoms: Are the neurological symptoms focal? Are the neurological symptoms negative rather than positive? Was the onset of the focal neurological symptoms sudden? Were the focal neurological symptoms maximal at onset rather than progressing over a period? If the answer to all four questions is yes the symptoms are likely to be vascular in origin. The overall risk of stroke following TIA is 2.1% at two days and 5.2% at seven days. Patients at higher risk of subsequent stroke include those with: motor symptoms; high blood pressure; longer duration of symptoms and diabetes. The ABCD2 score is recommended to differentiate between high-risk TIAs that need specialist assessment and investigation within 24 hours of symptom onset and low-risk TIAs that need assessment within one week. Any patient in atrial fibrillation (AF), on anticoagulants or with two or more TIAs in a week should be referred for urgent assessment, whatever their ABCD2 score.