Diabetes is an important risk factor for the development of ischemic cerebrovascular disease or stroke. Diabetic patients are more susceptible to atherothromboembolic brain infarction and its consequent mortality than nondiabetic patients. Cerebrovascular disease in the diabetic population somewhat follows the same pattern as in the nondiabetic population, however, with greater severity in outcome for the former. The etiopathogenetic mechanisms of strokes and transient ischemic attacks in diabetic patients are apparently due to cerebral hemodynamic and vascular derangements, hyperglycemia, and other related risk factors. There is a great disparity in the wider information on coronary heart disease and stroke than on diabetes and stroke. A better understanding is required for the determinants of stroke and diabetes, and the epidemiology and pathophysiology of specific risk factors in different racial groups. There is a similarity in the evaluation, assessment, and management of diabetic and nondiabetic patients.