The management of ischemic stroke is currently adapted in stroke unit. IV thrombolysis and mechanical thrombectomy are the most effectiveness treatments.We report the case of 54-year-old patient, who was admitted in our department for sudden left hemiparesis. According to initial examination and CTscan, he needs treatment by IV thrombolysis and mechanical thrombectomy, but in Congo mechanical thrombectomy is not available. He has IV thrombolysis alone, without success. The control CT-scan showed malignant infarction for which thrombectomy was not indicated. The patient died 24 hours after.