Sistem skoring Alberta Stroke Program Early CT Score (ASPECTS) merupakan alat skoring semi – kuantitatif sederhana untuk mengevaluasi gambaran iskemi akut pada CT scan non kontras atau MRI. Pada awal publikasinya, sistem skoring ini dianggap dapat memprediksi outcome fungsional dan kejadian transformasi perdarahan pada pasien yang menjalani trombolisis intravena dengan alteplase. Namun rekomendasi terbaru tidak lagi merekomendasikannya. Data efektivitas trombektomi mekanik pada populasi dengan nilai ASPECTS ≤ 5 belum cukup. Tulisan ini membahas cara menilai, kegunaan serta implikasi sistem skoring ASPECTS terhadap tatalaksana pasien dengan stroke iskemi akutAlberta Stroke Program Early CT Score (ASPECTS) is a simple semi-quantitative scoring system to evaluate the noncontrast CT Scan or MRI imaging of acute ischemic lesion. Originally, the scoring system was considered able to predict the functional outcome and hemorrhagic transformation in patient undergoing intravenous thrombolysis with alteplase. However, the latest guideline does not recommend ASPECTS to determine the eligibility of patient undergoing alteplase therapy. Data regarding the efficacy of MT in patient with ASPECTS ≤ 5 is scarce and is still a subject of debate. This article will discuss the evaluation and the implication of ASPECTS scoring system in the management of acute ischemic stroke.