There is a need for improved therapies, in terms of utility and effectiveness, for stroke patients; however, over the years, numerous clinical trials of potential drugs have failed to demonstrate positive results. The emerging field of stem cell research has raised several hopes of a therapy for neurological diseases, including stroke. This review discusses the recent clinical trials and pilot studies using stem cells in stroke patients and highlights key issues that must be addressed to improve the chances of successfully developing a new strategy for stroke patients using adult stem cells.