1. There have been many advances in stroke research and care over the past year. The aim of the present review is to highlight the significant advances that are likely to have considerable impact on the direction of future investigations and models of clinical practice. 2. In terms of the acute treatment of stroke, there is now Level I evidence for the use of thrombolysis in the treatment of ischaemic stroke. The results of clinical trials suggest potential new treatments for stroke of inherited origin, whereas other potential treatments have been suggested following the identification of a novel mechanism of emboli clearance by extravasation. Clinical guidelines have also been updated, with tight blood pressure control advocated in cases of acute intracerebral haemorrhage. 3. In terms of stroke prevention, new information has been added to the long-standing debate regarding the value of carotid stenosis management: the predictive value of asymptomatic carotid emboli may enable the identification of individuals at high risk of stroke. Furthermore, the identification of novel risk factors for stroke opens up new avenues for stroke prevention. 4. Robot-assisted therapy has heralded a new era in stroke rehabilitation and the 'Get With The Guidelines' programme has set a milestone in the quality control of stroke care. 5. Undoubtedly these advances will have a marked impact on future research and clinical practice.