Stroke in childhood and adolescence is a rare pediatric disease. Children affected by stroke suffer from neurological and neuropsychological impairments. The character and the complexity of cognitive impairments depends on age at stroke and localization. Neuropsychological assessments can provide support for the therapy of cognitive impairments and academic performances. Attention and memory disorders also play an important role in judging intelligence in children with stroke. Due to the variety of impairments a multidisciplinary approach is necessary.