Nowadays, stroke is the most frequent cause of adult disability and death of the elderly. In most cases, the etiology of stroke involves cerebral ischemia. Ischemia-induced changes in the brain tissue lead not only to its degeneration, but also to significant activation of cellular mechanisms which protect the affected cells from damage. One such mechanism is the expression of endogenous neuroprotective substances, for example pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intenstinal peptide (VIP), whose properties were investigated recently. PACAP and VIP are neuropeptides widely distributed in both the central nervous system and peripheral organs of various vertebrates. They display pleiotropic biological activity. An extremely strong neuroprotective potential of these peptides has been observed and confirmed in numerous animal models. The protective mechanism of PACAP and VIP involves many intracellular pathways, which can be generally classified into four categories of action: antiapoptotic, anti-inflammatory, metabolic, and modulation of gene expression. Numerous data provided by many research centers suggest that endo- and exogenous PACAP and VIP, as well as their synthetic derivatives, reveal considerable neuroprotective and anti-inflammatory potential, suggesting a possibility of their use as new therapeutic strategies in stroke treatment.