More than 10 years past, since the acute thrombolytic therapy using recombinant tissue plasminogen activator (rt-PA) was officially adopted for the acute therapy for ischemic stroke patients in Japan. At the beginning, rt-PA was allowed to administrate within 3 hours after the stroke onset, and the number of rt-PA treated patients were in less than 5% of all acute stroke patients . Although the time limit was recently extended to 4.5hrs , the number of patients who were treated with rt-PA was not dramatically increased. Recently, it was reported that the rate of thrombolysis in older adults has increased in the United States, from 1.7% to 5.4% (2005-2010 trend) . In mean time, these days, the methods of mechanical thrombectomy have been improving, and this therapy combined with medical management could be safely performed within 8hrs following the stroke onset . Since various therapies have presented as the gospel for acute ischemic stroke patients, it is desirable to increase the number of patients who admitted in hospital at the very early phase of stroke. However, because the initial symptoms of the stroke are various, it would be difficult to decide to go to hospital immediately. Actually, many campaign for stroke awareness, including Act FAST (face, arm, speech, time) campaign , have been conducted across the globe, but it’s effect was limited and short . Thus far, this study can be a good material for thinking about effective campaign to create awareness on stroke, the clinical distinctive features of acute stroke patients who admitted in the hospital later than 6hrs of stroke onset were investigated by comparing with those of patients who admitted in the hospital within 6hrs and treated with thrombolytic therapy and/or thrombectomy.