Do you remember those key teaching points for stroke? “The brain dies within minutes of a stroke”, “the time limit for thrombolysis is 3 hours”, “surgery is ineffective for most people with intracerebral haemorrhage”, “best not to intervene in blood pressure management in the acute phase of stroke”, “early rehabilitation is key”, “nothing works for haemorrhagic stroke”. We now have strong clinical trial evidence of the value of revascularisation, that for some, can be up to 24 hours after stroke onset. Advanced imaging supported by Artificial Intelligence is already supporting revascularisation decisions across much of Australia. The evidence base for the management of those with haemorrhagic stroke continues to grow, with blood pressure manipulation, selected neurosurgery (particularly minimally invasive techniques), active management and reversal of anticoagulation contributing to improved outcomes. Early rehabilitation is still important – but not too early! Adding to this evidence base are the great outcomes being seen in the successive roll out of telestroke services across Australia, delivering these treatments to those in rural and more remote areas devoid of stroke specialists. More recent evidence has also supported the importance of doing the simple things well, by an expert team – the key underlying mechanism to explain the benefit of stroke unit care (and analogous to much geriatric medicine). Future challenges include the known cognitive biases of different medical disciplines, addressing frailty, keeping a watchful eye on those falls deaths (particularly those on anticoagulants) and the really difficult challenge of getting stroke treatment rates up to national benchmarks – as many quality indicators are stuck at inadequate levels.