The use of recombinant tissue plasminogen activator (rtPA) has been the standard of care for treatment of acute ischemic stroke for several years. Studies evaluating the efficacy, safety, and optimal timing of rtPA use are ongoing. Recently, results of new studies led to expansion of the short timeframe from stroke symptom onset in which a patient can receive this treatment. Additionally, more data are available to support the current goals of administration of rtPA to eligible patients as quickly as possible, as earlier treatment has been proven to improve outcomes.