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Perioperative stroke can be a devastating complication of surgery and has a particularly high incidence in association with vascular procedures such as carotid endarterectomy (CEA). This chapter presents a case study of a 75-year-old right-handed male with a history of a previous stroke 1 month before admission, which manifested as left upper extremity weakness that steadily improved over about a week. The patient was taken for arterial thrombolysis with a mechanical clot retrieval device. Postprocedure, he was awake with slightly improved arm and leg strength on the left side. A number of studies have shown that the risk of subsequent stroke is decreased in correctly selected patients who have CEA. Improvement in stroke outcome has been shown to correlate with early and aggressive physical therapy and rehabilitation. This is an important and potentially overlooked aspect of care in patients with stroke after any surgery.