Stroke prevention is highly effective but underutilized in medical care. Lifestyle modification, in the form of diet, exercise,
smoking cessation, antihypertensive therapy, close control of diabetes and hyperlipidemia, can prevent most strokes. Selected subgroups
can benefit from carotid surgery or stenting, anticoagulation for atrial fibrillation, and antiplatelet therapy. Evidence for these approaches
and alternative management strategies are discussed.