Systemically administered gangliosides have been shown to be pharmacologically effective in reducing injury and facilitating recovery after CNS damage in various animal paradigms. Very recent work has indicated that ganglioside therapy following CNS ischemia in animals and in humans causes reductions in the extent of injury (acute phase) and enhanced neurological recovery (long-term effects). These studies are reviewed, and the possible mechanisms (i.e., the protection of plasma membrane integrity/function and the modulation of trophic factors) by which gangliosides protect against and reduce brain injury are discussed.