BACKGROUND The authors summarised their experiences of systemic intravenous thrombolysis using recombinant tissue-type plasminogen activator with 3 hours therapeutic window in acute ischaemic stroke. OBJECTIVE The aim of this work was to test the safety and efficacy of systemic thrombolysis in our unselected, community-based patient population. RESULTS The mean door-to-needle time was 45 minutes, the number of bleeding complications and successful recanalisation was similar to the results of the large international trials. In spite of these facts the functional outcome of our patients turned out to be worse. Compared to the baseline characteristics of the international trials the initial neurological deficit--a well known bad prognostic parameter- and also the comorbidity of our patients was more severe. CONCLUSIONS In Hungary only patients with alarming, initial symptoms arrive quickly enough for thrombolysis to the hospital, while in most of the patients with less severe stroke symptoms the delay for hospital admission is more than 3 hours. The authors assume that with more effective patient education it might be possible to solve this problem and make thrombolysis to exert a greater impact on the effectiveness of the acute stroke therapy.