This activity will provide an updated, mechanism-based review of secondary stroke prevention following ischemic stroke and TIA. The session focuses on evidence-based medical management, including antithrombotic selection (antiplatelet and anticoagulation therapy), blood pressure control, lipid-lowering strategies, glycemic management, procedural interventions, and behavioral interventions. Learners will review practical decision-making for dual antiplatelet therapy duration, atrial fibrillation detection and anticoagulation timing, management of embolic stroke of undetermined source, and optimization of vascular risk factors. Content is based on contemporary clinical trials and guideline recommendations, with application through real-world clinical cases.