Pediatric stroke had its origins from three fields: adult stroke, pediatric neurology, and thrombotic disorders [1]. Each discipline evolved from different directions and provided unique but complementary perspectives. From the sixteenth to nineteenth century, autopsies showed brain hemorrhages and brain softenings or porencephaly underlying “infantile paralysis.” The vascular basis of apoplexy established in adults was eventually realized in children. From 1900 to 1950, classification of neurological impairment associated with pediatric stroke subtypes emerged, including congenital hemiplegia and acquired apoplexy, arterial versus venous thrombosis, and, in the pre-immunization era, a strong association with childhood infections. From 1950 to 2000, development of computed tomography and magnetic resonance imaging in the 1970s and 1980s provided in vivo imaging signatures of pediatric stroke from acute onset to chronic recovery. Neuroimaging improved the ability to detect stroke across the pediatric age spectrum. The images provided by analysis of tomographic and magnetic resonance imaging (MRI) sequences accelerated the ability to detect, characterize, and understand pediatric stroke. An increasingly detailed landscape of pediatric stroke and its recognizable subtypes emerged: primary brain hemorrhage, brain arterial occlusion with focal infarction, and intracranial venous occlusion. Noninfectious etiologies causing stroke were increasingly recognized, including cardiogenic, arteriopathic, prothrombotic, and hematological disorders. Networks of collaborators accelerated discovery. Two major developments launched the field of pediatric stroke as an important pediatric neurology subspecialty: neuroimaging and the formation of collaborative networks of clinician-researchers.