Although evidence indicates that the incidence of stroke has declined over the past 30 years, stroke remains one of the leading causes of disability and death in the United States. Prevention appears to be the best treatment. According to the Straub Stroke Registry, 52% of strokes in its patient population can be attributed to a thrombotic mechanism. Besides thrombosis, the major causes of stroke are embolism, lacunar infarct, cerebellar infarction, and hemorrhage. Hypertension is a widely recognized risk factor for stroke, but the risks vary for each type of stroke. Transient ischemic attacks may precede stroke and thus are a warning signal. Since acute stroke cannot be cured, management includes symptomatic care and control of related problems such as hypertension. Carotid endarterectomy is useful in prevention of initial or recurrent stroke. The prognosis of stroke patients varies depending on the size of the lesion.