FLAIR vascular hyperintensities (FVH) are frequently encountered in acute ischemic stroke. We report two cases presenting with transient ischemic attack (TIA) with isolated FVH on MRI who went on to have a stroke during hospitalization. Isolated FVH may be an important imaging correlate in acute ischemia, and may suggest proximal occlusion with the presence of slow flow through retrograde leptomeningeal collaterals. Recognition of these subtle correlates may complement clinical predictors of stroke after TIA.