This article describes advances related to the successful remote evaluation of the patient with acute stroke. Telestroke is a connected care approach that brings expert stroke care to remote, neurologically underserved urban or rural locations. Recent findings reveal strong evidence showing that telestroke is equivalent to in-person care. Time is critical in treating patients with acute stroke, and telestroke networks must assure that technology improves—not delays—delivery of care. The stroke center and the spoke site must work collaboratively to develop and institute protocols and policies to ensure that eligible patients are identified, assessed, and treated swiftly. Adverse outcomes, such as intracranial hemorrhage and mortality, must be monitored to assess safety metrics. An additional goal of telestroke networks is to screen patients who might be candidates for potential endovascular or neurosurgical therapy and transfer these patients for these procedures.