Sonothrombolysis (ST) can increase the penetration of circulating tPA into the thrombus, promote the breaking and cleaving of the fibrin polymers, and improve the binding affinity of tPA to fibrin. A recent Cochrane Review of all the randomized studies published on ST reported significantly more recanalizations and better clinical outcome, with no effect on mortality. Two ongoing multicenter studies are verifying the efficacy and safety of ST in acute ischemic stroke. In both studies, endpoints will be clinical and sonological. ST is a promising tool for ischemic stroke treatment. Ongoing studies will provide us further data to be added to previous study and basis for more efforts in this promising direction.