Imaging in the acute setting of suspected stroke is an important topic to all emergency physicians, neurologists, neurosurgeons and neuroradiologist. When it comes to imaging, the American College of Radiology (ACR) continually updates its guidelines for imaging pathways through the ACR Appropriateness Criteria. 1,2 This article is a general review of the imaging modalities currently used to assess and help guide the treatment of strokes. [West J Emerg Med. 2011;12(1):67-76.]