Stroke is the most common life-threatening neurological disorder. Based on limited acute therapies, clinicians have opted to focus on preventive strategies to limit its recurrence. Targets for prevention include modifiable risk factors such as hypertension, diabetes mellitus, dyslipidemia, cigarette smoking, obesity, alcohol use, and physical inactivity among others. The American Stroke Association and American Heart Association guideline for the secondary prevention of stroke published in 2006 provides comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of stroke or transient ischemic attack. This guideline helps healthcare providers who have arrived at a potential explanation of the cause of stroke in an individual patient to select therapies that reduce the risk of recurrent events and other vascular events. The purpose of this review is to highlight the recently published American Stroke Association/American Heart Association guidelines for the secondary prevention of stroke.