At least three questions has to be answered by imaging methods, when new therapies in acute ischemic stroke should be used: 1. Is there a cerebral ischemia? 2. What is the size of the irreversible damaged tissue and what is the size of the safeable tissue? Is there still a vessel occlusion? New MRI-techniques including MR-angiography, diffusion-weighted imaging and perfusion-MRI, have the potential to describe the status of the brain in detail and to answer these questions. However, the value of these techniques for therapeutical decisions (thrombolysis) is unclear and has to be evaluated in clinical studies. Therefore in clinical routine these decisions should still be based on informations from CT and perhaps CT-angiography.