Stroke is a medical emergency and presents with focal neurological deficits. Immediate evaluation, confirmation  of diagnosis and treatment to re-establish blood flow leads to improvement in symptoms and prevention of brain damage. The diagnosis of acute ischaemic stroke is however not always straightforward. Similar symptoms may develop in a number of medical conditions commonly referred to as “stroke mimics’’.  Stroke mimics (SM) are non-vascular conditions that present with  an acute neurological deficit simulating acute ischemic stroke and represent a significant percentage of all acute stroke hospital admissions. Imaging is essential for Stroke mimics recognition, especially Diffusion weighted imaging (DWI). Imaging usually facilitates diagnosis, as stroke has typical imaging features at different stages and follows typical topographic patterns. Diffusion weighted MRI (DWI) is highly sensitive for identifying acute ischemia, it is a commonly performed MRI sequence for the evaluation of acute ischemic stroke and is very sensitive in the detection of small and early infarcts. Conventional MRI sequences (T1WI, T2WI) may not demonstrate an infarct for 6 hours, and small infarcts may be hard to appreciate on CT for days, especially without the benefit of prior imaging. Stroke "mimics" with restricted DWI include infection, status epilepticus, and acute hypoglycemia. These typically affect cortex in a nonvascular distribution while sparing the underlying subcortical white matter.