Thrombolysis is the only effective medical therapy for acute ischaemic stroke. The treatment has been approved in Europe since 2002. This article briefly summarises the pharmacological background of thrombolysis in cerebral ischaemic stroke. International experience with thrombolysis within the last decade as well as the successful implementation of thrombolysis in Denmark within the last 3 years is reviewed. Attention is drawn to new neuroradiological diagnostic techniques and future therapeutic possibilities.