Due to the lack of systematic research data on acute stroke in the pregnant and postpartum population currently, the clinicians always treat those patients according to their own experience. This situation has led to non-standard treatment and could not effectively protect the health of mothers and infants. In 2018, the Heart and Stroke Foundation of Canada (HSFC) combined with Canadian Stroke Consortium (CSC) published 2018 Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during Pregnancy. This consensus statement was developed by interdisciplinary cooperation between stroke experts and maternal-fetal experts, covering initial emergency management, imaging diagnosis, acute stroke treatment, hemorrhagic stroke management, anesthesia management, management in the gestational (prenatal, intrapartum and postpartum) stroke population, and secondary prevention and post-stroke rehabilitation. The evidence was primarily derived from studies of non-pregnant stroke or synchronous pregnancy groups. Pregnancy has been the exclusion criteria for almost all acute stroke trials and the cases of pregnant stroke are relatively rare, the high-quality evidence from randomized controlled trials is insufficient. Accordingly, this consensus statement used the data as evidence obtained by case reports, case series reports, and population-based registration studies. The recommendations of this consensus statement reflected expert opinions based on professional and clinical experience.