The advent of new MR techniques such as perfusion and diffusion weighted imaging has revolutionized diagnostic imaging in stroke. In some institutions, MRI is used as the sole screening imaging technique for acute stroke patients. In this document, the authors will review the MR pattern of acute ischemic arterial stroke, highlight the usefulness of MRI for the identification of acute hematomas and stroke like episodes, present the potential use of MRI in the management of acute stroke patients, especially when thrombolysis is contemplated, and discuss the role of MRI for imaging transient ischemic attack.