<p>Thrombolysis is a promising treatment for patients with acute ischaemic stroke. However, a major barrier to treatment is that it needs to be administered within 4.5 hours of stroke onset. Training and education is key to the timely delivery of thrombolytic therapy to patients following acute stroke. This article describes the thrombolysis care pathway in use in one hyperacute stroke unit and outlines the core competencies required of the acute stroke nurse.</p>