As American writer Robert Heinlein observed, “A generation which ignores history has no past and no future.” This insight underscores the importance of understanding the historical context of stoke, a significant global health challenge, being one of the leading causes of morbidity and mortality worldwide. Ancient records describe stroke-like symptoms, with Hippocrates’ term “apoplexy” referencing sudden paralysis, believed to result from imbalanced humors affecting the brain. After Renaissance with breakthroughs created by Andreas Vesalius’ anatomical studies, William Harvey’s work on circulation, Giovanni Battista Morgagni began linking clinical symptoms with brain pathology, identifying stroke as a cerebrovascular event by the eighteenth and nineteenth centuries. Key breakthroughs occurred in the late nineteenth and early twentieth centuries, as Rudolf Virchow detailed mechanisms of thrombosis and embolism, clarifying causes of ischemic stroke. Advances in neuroimaging, especially CT and MRI technologies in the late twentieth century, enabled rapid, precise stroke diagnosis and classification, reshaping the approach to treatment. This period also saw heightened attention to modifiable risk factors—hypertension, diabetes, and lifestyle—supported by epidemiological research. Therapeutic progress has been transformative in acute ischemic stroke care, enabling earlier intervention and improved outcomes. This chapter outlines the chronological development of stroke knowledge, examining how changing insights in pathology, technology, and public health informed stroke management. Through this historical lens, we trace the trajectory from ancient interpretations to modern, evidence-based practices in stroke prevention, diagnosis, and treatment.