Following the successful application of thrombolytic therapy for acute myocardial infarction, investigations have proceeded on several different thrombolytic agents as therapy for ischemic stroke. Early clot lysis has been demonstrated following both intra-arterial and intravenous drug administration. Clinical outcomes have been encouraging, but conclusions regarding efficacy must await the completion of randomized clinical trials. Intra-cerebral hemorrhage following thrombolytic therapy for ischemic stroke is not uncommon and may be fatal, and risk factors for this complication have been difficult to identify.