Thrombolysis in acute ischemic stroke remains the only effective treatment. Alteplase or recombinant tissue Plasminogen Activator (rt-PA) is the only drug approved and widely used. The use of tenecteplase is still studied (1,2). In subSaharan Africa, many patients, although eligible for thrombolysis, do not benefit for many reasons including accessibility to medical imaging, the lack of stroke unit, and the cost of thrombolytic drug. We report the first Congolese case of intravenous thrombolysis, using tenecteplase.