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Cerebral ischemic stroke is the leading cause of death and adulthood disability in developed countries such as the UK and USA. The only pharmacological treatment available is intravenous thrombolytic therapy, which is most effective and beneficial to patients when administrated within a relatively short time window following stroke onset. However, a large number of patients are ineligible for thrombolysis treatment due to delays in receiving treatment. In this review we discuss those factors which are associated with treatment delay. Understanding such factors that contribute to treatment delays, especially in different regions of the world, may help to improve the time at which treatment can be delivered to stroke patients and reduce the detrimental effects of stroke.