Intracranial blood vessel stenosis is a type of large cranial artery disease which can result in a transitory ischemic attack or an ischemic stroke via its progression. The ischemic stroke is the second most common cause of death in the Republic of Croatia, taking up 8,7% of all annual deaths, emphasizing importance of early disease recognition and swift reaction for the sake of timely treatment. A wide variety of underlying diseases and conditions may lead to the development of an ischemic stroke via primary disease progression. We discern intracranial artery stenosis and other ischemic stroke causes via modern techniques: patient history, examination, scoring systems for approximation of the neurological status (GCS) and severity of a stroke (NIHSS), noncontrast neuroimaging methods (MR and CT) and angiography technologies (DSA, MRA and CTA) with which the location of artery stenosis or occlusion and brain tissue ischemia are identified. Comparing neuroimaging methods with each other, one could say each of them have their advantages and shortcomings which define when it is best to use them, depending on the suspected stroke etiology and time of the onset of the disease. Present intracranial artery stenosis treatment strategies incorporate medical, endovascular and neurosurgical therapy options whose efficacies are being compared to each other in large-scale studies. Although clinical studies have been supporting the superiority of aggressive medical therapy with DAPT for intracranial stenosis treatment over endovascular interventions with stenting, newer stent designs have shown promising results in contemporary studies and have therefore earned stenting a place in standard of care for ICS. The ischemic stroke is a neurological emergency which requires care in a neurointensive care unit, followed along by endarterectomy and fibrinolysis, depending on the time interval between the onset of symptoms of the disease and possible therapy application. Even though neurosurgical approach to intracranial stenosis and acute ischemic stroke treatment has shown worse results than the standard of care so far, newer strategies for this type of treatment have also shown good potential for future use.