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The authors have no financial conflicts of interest. Stroke is the third leading cause of death and the most common cause of complex disability in Taiwan. The annual age-standardized mortality rate of stroke is steadily decreasing be-tween 2001 and 2012. The average years of potential life lost before age 70 for stroke is 13.8 years, ranked the fifth in the cause of death. Its national impact is predicted to be greater accompany aging population. The most common type of stroke was ischemic stroke in Taiwan. Small vessel occlusion was the majority of ischemic strokes subtype. Age, gender, hypertension, diabetes hyperlipidemia, obesity, atrial fibrillation, and smoking were impor-tant contributory factors to stroke morbidity. The standard treatment for acute ischemic stroke in Taiwan is providing the intravenous thrombolysis with recombinant tissue plas-minogen activator (IV tPA) therapy for ischemic stroke patients within 3 hours of symptom onset. However, the rate of IV tPA therapy for patients with acute ischemic stroke is still low in Taiwan. Therefore, improving the public awareness of stroke warning signs and act on stroke and improving in-hospital critical pathway for thrombolysis would be the most im