Ischemic strokes (IS) in children are rare but critical, presenting unique challenges due to age-specific factors. Defined by the American Heart Association as episodes of neurological dysfunction caused by focal infarctions, IS can lead to severe outcomes if not promptly addressed. Despite their rarity, pediatric IS requires careful management, complicated by the lack of validated treatment data for children. This study from the University Hospital Center of Oujda examines the management of acute IS in children, analyzing epidemiological aspects, clinical presentations, and therapeutic approaches. Results : 1. Population: 29 children, average age 3.5 years, slight male predominance (sex ratio: 1.2). 2. Consultation Delay: 14% were seen within 24 hours 50% after 7 days. 3. Symptoms: Motor deficit was the most common (82.7%). 4. Diagnostics: CT confirmed IS in 85% of cases MRI established etiological diagnosis in 51.8%, showing sylvian artery involvement in all patients. 5. Etiologies: Embolic cardiopathies (31.03%), vasculopathies (20.06%), and others such as hypertension and neurofibromatosis. 6. Treatments: Symptomatic management, motor physiotherapy, aspirin, and heparin. 7. Outcomes: 74% had complete regression of motor deficits, 20.6% had partial regression, and there were two deaths due to cardiogenic shock. The study underscores the need for a multidisciplinary approach to effectively manage IS in children and improve clinical outcomes.