The effectiveness of surgical prevention of ischemic stroke has been demonstrated in several international randomized studies. Issues about the surgery time, patient selection criteria, surgery techniques remained unresolved. We have reviewed 46 publications in this field. The current vast arsenal of surgical techniques allows to conduct revascularization surgery procedures in patients with acute ischemic stroke and lesions of extra- and intracranial arteries. The benefits of early carotid endarterectomy in patients with mild stroke and transitory ischemic attacks (TIA) are undeniable fact. Necessity of urgent endarterectomy and thrombintimectomy in patients with stroke, TIA, acute inner carotid artery occlusion is a subject of current discussions. The experience in performance of these interventions has been accumulated but randomized studies are needed to verify their effectiveness. Microsurgical techniques have made it possible to perform bypass surgery and open embolectomy in situations earlier considered as incurable.