The transition from alteplase (ALT) to tenecteplase (TNK) in the management of acute ischemic stroke (AIS) has been an exciting and thoroughly discussed topic within the neurocritical care community. Although debates on the clinical efficacy and safety of TNK for AIS have subsided somewhat in light of recently published data, what remains lacking is a clear “road map” for institutions on how to properly implement the transition in thrombolytics. Brian Gilbert, PharmD, and Katie Qualls, PharmD, join Dr Lauren Koffman to discuss the transition from ALT to TNK for AIS. You can read Brian and Katie's February 2023 article in Currents at https://currents.neurocriticalcare.org/Leading-Insights/Article/transitioning-alteplase-to-tenecteplase-for-acute.