Clinical trials of reperfusion therapies for acute ischemic stroke patients in an extended time window have shown mixed results. Advanced neuroimaging for stroke, more specifically vascular imaging and perfusion/penumbral imaging, have been hypothesized to be powerful selection tools in this setting. However, a number of improvements and validation steps are needed to make these imaging techniques operational and accurate in the stroke community in general. This article briefly describes the needs in this field and recommends future steps to achieve them.