The World Health Organization reports that stroke claims 6.2 million lives each year. There are ≈5.4 million stroke survivors with ≈80% requiring hand therapy. 1 The estimated economic burden for stroke exceeds $56.8 billion per year in the United States alone.Acute thrombolysis has a significant impact on the management of stroke, 2,3 with a therapeutic window that may extend ≤6 hours with intra-arterial delivery. 4 Yet only a minority of stroke victims benefit, and the majority experience progression of ischemia associated with neurological disabilities.Animal models that recapitulate human disabilities and disease pathology remain an unmet need in stroke research. There has been a tremendous advance in developing rodent experimental model stroke (reviewed in Durukan and Tatlisumak 5 and Carmichael 6 ). However, the lack of success in developing neuroprotective therapies in small animal models for stroke 7,8 prompted recommendations for additional research and development in large animal models with physiological, structural, and functional traits closer to those of humans before clinical trials.9,10 There has been a concerted effort in developing relevant large animal models. 11,12 Interspecies comparison suggests that cerebral venous angioarchitecture in large animals is closer to that of humans 13 ; nevertheless, such models remain relatively underdeveloped. Nonhuman primate (NHP) models offer an assessment of complex physiological, immunologic, biochemical, and behavioral outcomes most similar to those of humans.14-24 These outcome measures complement those from other animal models by improving our understanding Background and Purpose-Ischemic stroke is the leading cause of upper extremity motor impairments. Although several well-characterized experimental stroke models exist, modeling of upper extremity motor impairments, which are unique to primates, is not well established. Cortical representation of dexterous movements in nonhuman primates is functionally and topographically similar to that in humans. In this study, we characterize the African green monkey model of focal ischemia reperfusion with a defined syndrome, impaired dexterous movements. Methods-Cerebral ischemia was induced by transient occlusion of the M3 segment of the left middle cerebral artery.Motor and cognitive functions after stroke were evaluated using the object retrieval task with barrier-detour. Postmortem magnetic resonance imaging and histopathology were performed to map and characterize the infarct. Results-The middle cerebral artery occlusion consistently produced a necrotic infarct localized in the sensorimotor cortex in the middle cerebral artery territory. The infarction was reproducible and resulted in significant loss of fine motor function characterized by impaired dexterity. No significant cognitive impairment was detected. Magnetic resonance imaging and histopathology demonstrated consistent and significant loss of tissue on the left parietal cortex by the central sulcus covering the sensorimotor area. The results sug...