In the remote telehealth setting, computed tomography perfusion (CTP) provides important information in assessing the suitability of reperfusion therapy for patients with stroke syndromes. This review will discuss key concepts surrounding the use of CTP, including basic science, clinical applications, pitfalls, recent trials, and technical considerations. CTP can enhance decision‑making for patients who are in the extended window from stroke onset, and this review will address key concepts relevant to its use.