A 4 1/2-year-old girl with incontinentia pigmenti developed acute-onset hemiparesis. Magnetic resonance angiography revealed occlusion of the left middle cerebral artery. Many neurocutaneous syndromes have been linked to ischemic stroke syndromes. Incontinentia pigmenti has not been associated with stroke syndromes in the past; however, this report illustrates that the patient and her mother, who also has incontinentia pigmenti, may have had similar ischemic stroke events.