Endothelin-1 has been shown to aggravate the ischemic-reperfusion injury in the neocortex of rats. The purpose of this study was to examine the effect of an endothelin-converting enzyme inhibitor, CGS 26303, on neurological deficit, infarct size, and extent of edema after transient occlusion of the middle cerebral artery and bilateral common carotid arteries (triple vessel occlusion) in rats. In the pretreatment study, male Sprague-Dawley rats underwent a 90-minute triple vessel occlusion, and CGS 26303 was administered intravenously 30 minutes before triple vessel occlusion. The compound was subsequently administered at 6, 12 and 18 hours post-triple vessel occlusion, and neurological status was evaluated 1, 12 and 24 hours after triple vessel occlusion. Animals were sacrificed at 24 hours post-triple vessel occlusion, brains were perfusion-fixed, and infarct areas and brain swelling were determined. Total infarct areas were reduced when compared with vehicle-treated animals by 48%, 50%, and 57% in rats receiving CGS 26303 at 1, 3, and 10 mg/kg, respectively, while the neurological score was significantly improved in the highest-dose CGS 26303-treated group. In another study, CGS 26303 treatment was initiated 1 hour after triple vessel occlusion. Total infarct areas were reduced by an average of 42-50% in the CGS 26303 treatment group. Neurological scores of animals treated with CGS 26303 at 10 mg/kg were decreased by 59% and 45% upon evaluation at 12 and 24 hours post-triple vessel occlusion, respectively. These results demonstrate that CGS 26303 may have potential for the treatment of focal ischemic stroke.