Neurological and cardiovascular ischemic diseases represent the main causes of morbidity and mortality in the world. Physiopathological mechanisms present several similarities, based on "thromboembolic" events, as well as the pharmacological and percutaneous treatment options. We report a case of contemporary presentation of acute coronary and cerebral syndromes, successfully managed with a combined percutaneous intervention driven by the emergency setting. Whereas invasive revascularization represents nowadays the "gold standard" therapy for acute coronary syndromes, catheter-based treatment of acute stroke is not yet widespread and still under debate.