In recent years, the number of diagnosed cases of arterial ischemic stroke (AIS) in children has increased significantly. Intravenous and endovascular thrombolytic therapy of AIS is the most effective treatment for adults. Currently, the literature provides descriptions of a series of clinical observations in children with AIS, that received therapy with thrombolysis. This type of therapy is recommended to be performed on the basis of pediatric stroke primary centers. Since 2018, on the basis of the Center for Cerebrovascular Pathology Treatment, Morozov Children’s City Clinical Hospital, 34 children with AIS aged 3,5-14 years received intravenous thrombolytic therapy. The article describes the clinical observations of 4 patients with AIS who underwent treatment with thrombolysis. © 2020, Pediatria Ltd. All rights reserved.