Stroke is a rare but potentially devastating disease during pregnancy and puerperium. Pregnancy is well recognized as a risk factor for stroke. Accurate and timely identification of stroke is crucial for clinical practice. However, the optimal management of pregnant women with stroke remains a clinical challenge. Thus, identification of risk factors and modification of underlying pathophysiological mechanisms would be of great value for stroke prevention and management. In terms of pharmacological intervention, it is important to determine the safety of a drug for mothers, their fetuses, and nursing infants. Neurologists treat non-pregnant patients without those considerations. Based on the above issues, we have reviewed the current literature and summarized clinically relevant issues for obstetricians and neurologists in treating stroke during pregnancy and puerperium.