Abstract: Stroke is the world's second leading cause of death and one of the most serious central nervous system disorders threatening brain function. Currently, effective treatment options for stroke are limited, and the risks of ischemia-reperfusion injury and hemorrhagic conversion during treatment need to be addressed. Encouragingly, continuous development of nanotechnology has the potential to fill the gaps of conventional treatment strategies. Based on the pathological mechanisms related to stroke, the major barriers and coping strategies for nanomedicines entering ischemic or hemorrhagic region of the brain are systematically analyzed. By reviewing the latest research achievements of nano-targeted preparations for ischemic and hemorrhagic stroke, and proposing ideas for the design of nano-preparations that address ischemic stroke complicated with hemorrhagic transformation, this study aims to provide some reference for the rational design of nanomedicines delivery systems for stroke treatment in the future.