A transient ischemic attack (TIA) is a significant risk factor for stroke. According to the literature, TIAs occur in 40-50% of stroke patients. Often, TIAs go unnoticed by both patients and healthcare providers, varying in clinical severity. Patients with a history of TIA frequently present with arterial stenosis, cardiac pathologies, and TIA can be caused by phenomena such as vascular steal syndrome, microembolization, vascular spasm, or hypercoagulation. The hemodynamic mechanism of ischemic stroke and TIA is crucial in cases of severe carotid artery stenosis and internal carotid artery occlusion. Additionally, there is a need to develop a differentiated approach to managing patients based on the etiopathogenetic structure of the disease and stroke prevention strategies. According to the literature, almost all patients who have experienced TIAs report multiple episodes, often disregarding the transient neurological deficit. This results in a stereotypical pattern of TIA occurrence. Early diagnosis of TIA, clarification of its causes and mechanisms of cerebrovascular decompensation, and well-founded, targeted treatment can prevent severe complications in high cardiovascular risk patients and serve as a significant preventive measure.