Transient ischemic attacks are reversible neurologic events that herald potentially catastrophic strokes. Well designed studies have documented that approximately 10% of patients who have a transient ischemic attack will have a stroke within the succeeding 90 days; half of these strokes occur within 48 hours of the transient ischemic attack. Improved outcomes from transient ischemic attacks require a heightened awareness of the clinical features of transient ischemic attacks on the part of both patients and physicians. The significant potential for stroke in the immediate days after the transient ischemic attack imposes an urgency in the diagnostic evaluation of these patients. A review of the literature suggests that there is a need for pathways to promote facilitated evaluations of transient ischemic attack patients in order to identify underlying correctable pathologies, and to direct medical and surgical management strategies.