Nowadays stroke is one of the world leading causes of mortality and disability. In process of time the evolution in view about etiology, pathogenetic mechanisms and therapy of patients with stroke has underwent pivotal changes. In this work there have been elucidated contemporary theoretical and practical aspects of stroke treatment and prophylaxis based on the results of multicenter clinical trials and experience of leading foreign and native specialists. Much attention is devoted to the pharmacotherapy of patients with stroke. It is showed that application of neuroprotective drugs is of great importance, among which antihypoxants with pleiotropic action play a crucial role (mexidol).