Aim: The purpose of the study is to summarize and analyze the own results of treating patients with acute ischemic stroke (AIS) on anticoagulation therapy with rtPA. Material and Methods: For the period 2007 - 2013 are conducted 186 (3.1%) thrombolysis in patients with acute ischemic stroke, classified by using TOAST classification. It is performed laboratory test, CT scan of the brain. Neurological status is examined with NIHSS. Results: According TOAST, patients are classified as: 43.3% - with thrombotic stroke, 33.7% - cardioembolic stroke, followed by cryptogenic- 12.8% and lacunar- 10.8% stroke. From all 55 patients with cardioembolic stroke treated with rt PA, 48% were on vitamin K antagonist therapy with INR less than 1.5. The neurological deficit in admission, estimated with NIHSS, was 13.3 ± 6.9 points, after hospital discharge - 6.12 ± 5.1 points. Symptomatic intracerebral hemorrhage is observed in 6.6%. Conclusion: The study suggests relative low rate of treatment with thrombolysis in patients with AIS on anticoagulation therapy and similar rate of complications, compared with other studies. There is well-established protocol for patients taking vitamin K antagonist - thrombolysis is only indicated when the international normalized ratio (INR) is less than 1.5. However, there is no standard protocol for the use of thrombolytic therapies in patients who are using the new anticoagulants, because they are not readily detected by standard coagulation tests.