Stroke-like migraine attacks after radiation therapy, or SMART, syndrome is a rare late complication of brain radiotherapy, whose diagnosis is sometimes difficult. The clinical presentation is characterized by recurrent prolonged hemispheric neurological deficits, headache, seizures, etc. The neuroradiological pattern shows cortical gadolinium enhancement and swelling in the corresponding hemisphere and lobes. These neuroimaging features are transient in a variable time range, but SMART might be progressive or recurrent. The natural history was initially described as benign after steroid treatment, but less benign cases have been published. Diagnostic criteria have been recently updated and they may help to not miss this condition.