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Stroke is the leading cause of disability in developed countries, and investigations to identify ways to recover lost neurological function continue. The potential of stem cell therapy could be enormous, but current knowledge and techniques remain limited. In this review article, findings related to the therapeutic potential of acceleration of endogenous neurogenesis and neuronal stem cell transplantation are introduced. The therapeutic effects of acceleration of endogenous neurogenesis have been shown to be mild, but they improve neurological function significantly, and clinical trials are ongoing. In contrast, the potential of neural stem cell transplantation has been reported in many basic experiments, but current basic knowledge and techniques are likely to be insufficient to proceed to clinical trials. The possible missing elements for successful neuronal stem cell transplantation in patients with cerebral infarction are discussed.