Coronary artery disease, with its incidence being gradually increased, has become the leading cause of heart attack hospitalizations and deaths. Percutaneous coronary intervention (PCI) significantly improves the quality of life in the patients with coronary artery disease. What’s more, PCI has been regarded as the first choice for the patients because of its simple operation, less painfulness, small risk, fast recovery, and other advantages. However, it may cause acute stroke, though with very low incidence. But the consequences are very serious, and even life threatening. The survivals usually are complicated with different severity of aphasia and extremity dysfunction and other symptoms. In this article, we reviewed the pathogenic mechanism, risk factors, treatment and prognosis of acute stroke in the patients with coronary artery disease after PCI.