In Improving Door-To-Needle Time and Systems of Care in Acute Ischemic Stroke: A Meeting of the Minds, professional emergency physicians and neurologists equip learners with present day stroke management and how outcomes from recent trials may change clinical practice by offering long-awaited results to stubborn, age-old questions. Staff present fact-based insight on how to decrease door-to-needle time and enahnce patient outcomes by working within established stroke systems of care, while taking into consideration the efficacy and security of varying therapeutic options available for the treatment of AIS. Stroke management is time sensitive. Treatment options for acute ischemic stroke (AIS) have grown from uncomplicated supportive care to intricate decisions that require intravenous (IV) thrombolysis and endovascular procedures. The safety and efficiency of IV and intra-arterial (IA) thrombolysis have been argued and tested for decades in many trials. Benefits of clot retrieval devices have been questioned. Who benefits the most from them? What are potential risks? How can these treatments and methods be used safely?