The current European licence for the thrombolytic agent alteplase prohibits the use of intravenous thrombolysis within 3 months of a previous stroke event, but this guidance has been challenged by new data from the SITS-EAST registry. In a retrospective study with 13,007 participants, intravenous thrombolysis produced similar outcomes in patients with first-ever stroke and individuals who had experienced a stroke ≤3 months earlier, suggesting that a recent history of stroke should not be a contraindication to use of this intervention.