Background: Although the efficacy of intravenous thrombolysis (IV-T) has been widely demonstrated, the rates of its use continue to be low Purpose: The purpose of this study was to assess the frequency of IV-T in Mexican hospitals and to describe the target times for acute treatment and the functional evolution of patients Methods: Data prospectively collected from patients with acute ischemic stroke treated over a period of 2 years in four Mexican hospitals were analyzed. We assessed demographic data, the onset-to-door (OTD) time, the door-to-needle (DTN) time, treatment and the National Institutes of Health Stroke Scale (NIHSS), and modified Rankin scale (mRs) scores at the baseline and at the end of the follow-up Results: There were 500 patients (mean age 57 ± 14 years, 274 [55%] men). The median OTD time was 11 h (range 30 min-190 h); the mean of NIHSS score was 10 ± 6. Eighty-seven (17.4%) patients arrived at the hospital within 4.5 h; but only 38 (7.6%) patients were treated with IV-T (mean of NIHSS 12 ± 6 points; with a mean OTD time of 2.1 h and a DTN time of 82 ± 51 min). After a median follow-up of 6 months (range 5-24 months), the final NIHSS score was 7 ± 6 points. A better prognosis was observed (mRs < 2) in patients who received IV-T (p = 0.04) Conclusions: The frequency of IV-T in Mexican hospitals continues to be <10%. A high percentage of patients continues to arrive at the hospital outside the therapeutic window.