Perinatal stroke is a heterogenous group of neurovascular injuries that occur between 20 weeks’ gestation and 28 days after delivery. Perinatal stroke subtypes include arterial ischemic, hemorrhagic, and venous infarction, which can be further classified by timing of diagnosis into the broad categories of fetal/preterm, term neonatal, and chronic. The risk factors for each subtype reflect the different mechanisms and timing of stroke. Acute treatments for neonates focus on neuroprotection and family-centered care. Long-term strategies potentiate the neuroplasticity of infants and children with focused, evidence-based rehabilitation techniques with many children achieving high participation in life.