The goal of stroke imaging is to appropriately select patients for different types of therapeutic management in order to optimize outcome and minimize potential complications. To accomplish this, the radiologist has to evaluate each case and tailor an imaging protocol to fit the patient’s needs and best answer the clinical question. This review outlines the routinely used, current neuroimaging techniques and their role in the evaluation of the acute stroke patient. The ability of computed tomography and magnetic resonance imaging to adequately evaluate the infarcted brain parenchyma, the cerebral vasculature, and the ischemic, but potentially viable tissue, often referred to as the “ischemic penumbra,” is compared The authors outline an imaging algorithm that has been employed at their institution, and briefly review endovascular therapies that can be used in specific patients for stroke treatment.