Imaging is essential for accurate diagnosis and timely treatment of acute ischemic stroke (AIS), which is caused by an occlusion of an intracranial artery. There are typical findings on imaging that lead toward correct and timely diagnosis. The two major treatment options for AIS patients are endovascular treatment and intravenous thrombolysis, both of which are highly time-dependent. Thus, the overarching goal of acute stroke imaging is to allow for accurate and fast diagnosis, which, in turn, results in faster treatment and ultimately in better patient outcomes. This chapter will outline the typical imaging findings of AIS and point out some of the pitfalls in acute stroke imaging, with special emphasis on the imaging findings that are of relevance for treatment decision-making and patient management.