Emergency management of cerebral infarct aims to confirm the diagnosis, determine the mechanism and the cause (on which depend the prognosis and treatment), prevent and treat immediate, general and neurologic complications and to begin as early as possible the appropriate treatment. A first progressive step was made with the creation of hospital units devoted to management of cerebrovascular accidents. Various studies showed that patients hospitalised in such units have not only better survival and functional prognosis, but also that the length of hospitalisation and the number of patients requiring subsequent hospitalisation in rehabilitation centres are significantly reduced. More recently, clinical trials suggested that thrombolytic treatment, although comprising a risk of severe cerebral haemorrhage, can clearly improve patient prognosis if it is given in the first hours. Cerebral infarct should henceforth be considered as a medical emergency, and our health care system should be adapted to give patients the best chance of cure.