Large-vessel ischaemic strokes have a very poor natural history. Thombolysis is indicated for the treatment of ischaemic stroke but in practice is given to less than 10% of stroke sufferers, and its efficacy in large-vessel occlusion is poor. Mechanical embolectomy is a new therapy that allows attempted revascularisation up to eight hours after stroke onset. With its improved efficacy, it therefore offers some hope to patients admitted with this devastating condition.