There have been numerous failures in the field of acute stroke therapy over many years, but the first large clinical trial showing preliminary indications of efficacy and safety of a neuroprotective drug, NXY-059, has now been fully reported. If confirmed, it will mean that a second therapy for acute stroke has been identified and neuroprotective drug development as a class can proceed. Additionally, a new class of drugs, HMG CoA-reductase inhibitors (statins), specifically high-dose atorvastatin, has been shown to be safe and effective for secondary stroke prevention. This drug should now become a regular part of stroke patient care.