Stroke is rare in children but leads to significant morbidity and mortality. Emergency department physicians are likely to be the first to evaluate children suffering strokes and it is, therefore, important for them to recognize common presenting features and risk factors for pediatric stroke. This review describes the epidemiology, clinical presentations, stroke types, associated risk factors, evaluation, treatment, and prognosis of pediatric stroke. Further research is needed on the acute and preventative treatments of pediatric stroke because merely applying our knowledge of stroke in adults to children is insufficient.