Modern multimodal acute stroke computed tomography (CT) includes noncontrast cranial CT (NCT), CT angiography (CTA), and CT perfusion imaging (CTP). Compared to stroke MRI, NCT is faster and easier. Multimodal CT can determine acute stroke etiology: Is arterial occlusion or intracerebal hemorrhage present? How extensive are the perfusion disturbance and infarct core, respectively? The information from NCT is sufficient for making acute stroke thrombolysis decisions within 4.5 h from symptom onset. The therapeutic effect of CTA and CTP--as well as acute stroke MRI--on improved functional outcome has still not been established.