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Although cardiovascular side effects of sildenafil are recognized, little is known about stroke risk in patients who take this drug. We report a patient with multiple strokes in the posterior cerebral circulation in close temporal association with sildenafil use. This case report further emphasize that stroke is, although rare, real side effect of sildenafil. Potential users should be warned before taking it, especially if they have other stroke risk factors, as recommended by the manufacturer.