Ischemic stroke is a leading cause of death and disability worldwide, with a complex pathogenesis and limited therapeutic options. In recent years, nano-drug delivery systems (NDDS) have shown great potential in the treatment of brain diseases. Nanocarriers can transport drugs across the blood-brain barrier and target diseased cells through the modification of targeting ligands. This article reviews the pathogenesis of ischemic stroke and the limitations of current therapeutic approaches, focusing on the progress of nano-drug delivery systems in the treatment of ischemic stroke. The challenges and future directions in this field are proposed, aiming to advance the development of nanomedicine delivery systems for the treatment of ischemic stroke.