Stroke is a leading cause of death and disability worldwide, with endovascular thrombectomy (EVT) significantly reducing mortality rates. However, many patients still experience suboptimal functional outcomes despite high recanalization rates, highlighting the need for adjunctive therapies in post-thrombectomy care. Recent preclinical studies have focused on preventing oxidative stress through upregulation of antioxidants and downstream effectors, showing promising results. Advances in multiple neuroprotective therapies, including uric acid, activated protein C, nerinetide, otaplimastat, imatinib, verapamil, butylphthalide, edaravone, nelomendaz, ApTOLL, regional hypothermia, remote ischemic conditioning, normobaric oxygen, and nuclear factor erythroid 2-related factor 2 (Nrf2), have shown potential in improving stroke care. Additionally, sedation and blood pressure management during EVT play crucial roles in enhancing stroke outcomes. A combined approach of endovascular therapy and neuroprotection may be key to reducing disability due to stroke. The article reviews the current state of stroke epidemiology, pathophysiology, and treatment options, emphasizing the importance of neuroprotective therapies and anesthetic management in improving functional outcomes.Stroke is a leading cause of death and disability worldwide, with endovascular thrombectomy (EVT) significantly reducing mortality rates. However, many patients still experience suboptimal functional outcomes despite high recanalization rates, highlighting the need for adjunctive therapies in post-thrombectomy care. Recent preclinical studies have focused on preventing oxidative stress through upregulation of antioxidants and downstream effectors, showing promising results. Advances in multiple neuroprotective therapies, including uric acid, activated protein C, nerinetide, otaplimastat, imatinib, verapamil, butylphthalide, edaravone, nelomendaz, ApTOLL, regional hypothermia, remote ischemic conditioning, normobaric oxygen, and nuclear factor erythroid 2-related factor 2 (Nrf2), have shown potential in improving stroke care. Additionally, sedation and blood pressure management during EVT play crucial roles in enhancing stroke outcomes. A combined approach of endovascular therapy and neuroprotection may be key to reducing disability due to stroke. The article reviews the current state of stroke epidemiology, pathophysiology, and treatment options, emphasizing the importance of neuroprotective therapies and anesthetic management in improving functional outcomes.