Thromboembolism, both venous and arterial, is a well-known complication of inflammatory bowel disease, with the risk of stroke highest when patients are less than 50 years of age. Because inflammatory bowel disease patients often have gastrointestinal bleeding, it is a challenge to treat their thromboembolic events with systemic therapy. In this case, a 42-year-old woman with Crohn's disease developed a thromboembolism in her middle cerebral artery and was successfully treated with local intra-arterial thrombolysis. There is a growing trend to treat thromboembolic events in inflammatory bowel disease patients with local thrombolysis as it leads to better outcomes with regards to both the resolution of the thromboembolism and decreased secondary gastrointestinal bleeding.