The challenges of translating neuroprotective interventions with promising efficacy in animal studies into effective treatments for patients with stroke are well documented, with issues including overoptimistic therapeutic windows, poor bioavailability, and heterogeneous clinical cohorts.1,2 Yet, preservation of the ischaemic penumbra during emergency stroke care remains an attractive concept. In The Lancet Neurology, Michael Tymianski and colleagues report an individual patient data meta-analysis of three randomised trials,3 showing promising findings that provide a rationale for further research into neuroprotection with the agent nerinetide.