Stroke in children, both ischaemic and haemorrhagic, is increasingly recognised as an important paediatric illness. This review looks at the wide number of causes, highlighting the fact that often no single factor is causative on its own. There has been an increased recognition worldwide of the importance of sickle cell disease and of the importance of venous sinus thrombosis. Radiology is mandatory in diagnosis and management. Unfortunately, it is not always possible to extrapolate experience from adult stroke in terms of management of these children, and further detailed trials are necessary to understand the natural history, outcome and best forms of management.