Therapy following an acute cerebrovascular insult traditionally has focused on preserving function of the uninjured cerebral tissue. However, in recent years, interest has developed on the possibility of restoration of function to the injured areas of the brain. Lessons learned in reperfusion following acute myocardial infarction have raised newer questions about the utility of reperfusion to other areas of the body subjected to acute ischemic events. In addition, studies with acute cerebral ischemia have suggested that calcium channel antagonists improve outcome, either by decreasing cerebral vasospasm, offering neuronal protection by inhibiting the formation of toxic metabolites in the injured neurons, or by some combination of these two mechanisms. Other experimental therapies, such as the use of hypervolemic hemodilution, attempt to restore cerebral blood flow following an acute vasospasmic or thromboembolic event. As these new therapies develop, we will see a major emphasis on restoring cerebral function following acute stroke.