To study the efficacy and safety of thrombolytic therapy (TLT) with the recombinant tissue plasminogen activator (rt-PA) in stroke, we treated 691 patients in 48 clinical units using systemic or selective TLT. Safety and high efficacy of TLT was shown: the three-months fatality rate was 18.2%, the symptomatic hemorrhage transformation rate related to clinical worsening was 6.1%. The good functional recovery (scores 0 or 1 on the modified Rankin scale) was observed in 48.6% of patients.