The Stanford Stroke Center, one of the first comprehensive multidisciplinary centers of its kind, was established in 1992 to develop new approaches to diagnose and treat stroke. The mission of the Stroke Center is to be the best comprehensive organization in the United States focused on stroke diagnosis, treatment, research, and education. In 1992, the Center was established by a team of neurologists, neurosurgeons, neuroradiologists, nurse specialists, basic scientists, and clinical researchers. This multi-disciplinary team has met regularly to continually refine the program for 30 years. In 2012, the Joint Commission and the American Heart Association/American Stroke Association announced that the Stanford Stroke Center was the first hospital in the United States to meet The Joint Commission's standards for Disease-Specific Care Comprehensive Stroke Center Certification. Stanford was chosen to be one of the original StrokeNet Regional Coordinating Centers (RCCs). During the initial grant period, Stanford developed the DEFUSE 3 study, which became the first clinical trial to be funded and executed by StrokeNet. This 40-site trial that tested the efficacy of endovascular therapy in the delayed time- window among patients selected with advanced neuroimaging techniques was extremely successful; enrollment rates were substantially ahead of projected targets and the trial stopped early for efficacy. The publication of the DEFUSE 3 trial results instantly changed practice guidelines and clinical practice around the world. It is now standard of care to treat patients with endovascular therapy in the delayed time-window if they meet DEFUSE 3 imaging criteria. This change in practice has nearly doubled the number of patients that can be treated with endovascular therapy. Stanford’s regional network is one of the highest enrollers in StrokeNet studies and Stanford faculty have made major contributions to key StrokeNet committees. The Stanford-RCC will continue to provide high volume enrollment of diverse patient populations into NINDS funded stroke trials. The Stanford RCC will also continue to offer an innovative multidisciplinary fellowship program that provides comprehensive training in clinical trial design, implementation and analysis. In addition, Stanford faculty members will continue to propose new clinical trials for implementation through StrokeNet.