Blood pressure lability is a phenomenon in which there is a wide range of extreme highs and lows in blood pressure measurements. These highs and lows occur at irregular intervals, and it is difficult for health care providers to isolate when this phenomenon occurs. Hypertension and hypotension occurring within minutes of the other can cause a showering of embolized blood clots to travel to the brain, heart, or lungs. The labile nature of the blood pressure can lead to the evolution of an ischemic stroke, heart failure, angina, and myocardial infarction. The aim of this article is to describe the relationship between blood pressure lability and ischemic stroke, including triggers, implications, and treatment options. A case study is included to illustrate treatment options available to health care providers.