Mineyko A, et al. - Individuals with bilateral, large vessel perinatal arterial ischemic stroke were recognized from a large, population-based cohort (Alberta Perinatal Stroke Project) in order to identify the phenotype and outcome of children with bilateral, large vessel perinatal arterial ischemic stroke. Of 174 infants with perinatal arterial ischemic stroke, eight had bilateral large artery infarcts. All children had a total Pediatric Stroke Outcome Measure of ≥ 2 and Gross Motor Function Classification System ≥ II. A history of epilepsy was noted in seven of eight children. Thus, infants with bilateral, large vessel perinatal stroke are at great risk of severe cognitive and motor sequelae. Moreover, epilepsy could also be more prevalent compared with unilateral strokes. Cautious discussions with families about prognosis are suggested.