Purpose of Review <p>Three-quarters of stroke survivors experience fatigue, yet its management remains suboptimal due to uncertainty about therapeutic options and underpinning evidence. Given the diverse causes and varying patient preferences, various strategies—ranging from pharmacological to non-pharmacological treatments—are being explored. A clearer understanding of these options' effectiveness would help prioritize those most suitable for clinical evaluation.</p> Recent Findings <p>Twenty studies involving 1,163 participants were extracted, including 12 randomized clinical trials, 2 non-randomized clinical trials, 1 post hoc follow-up study, and 5 treatment protocols or abstracts for studies. Most treatment options demonstrated significant improvements, reported as changes in fatigue and/or quality-of-life measurement scales (scores) or changes in the proportion of patients reporting an improvement. Variability in outcome measures precluded a comparison of efficacy between treatment options. Specific conventional mono-pharmacotherapies (e.g., modafinil) were shown to be most effective, reducing fatigue in up to 81% of patients whilst cognitive behaviour-based interventions reduced fatigue in 24–60% of stroke patients. Complementary therapies (acupuncture, Astragalus membranaceus) reduced fatigue scores by 42–45% and were most effective when used in combination therapies; Traditional Chinese medicine (Qi Supplementing Dominated Chinese Materia Medica) plus physical rehabilitation significantly reduced mean fatigue scores by 66%.</p> Summary <p>Presently, conventional 。pharmacotherapies appear to be the most effective option for managing post-stroke fatigue. However, further trials are needed to confirm their long-term effectiveness, safety, cost-effectiveness, and patient acceptability. More research is necessary to explore the full and diverse range of treatment options.</p>