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Background and aims: Central retinal artery occlusion (CRAO) is a rare but significantly underestimated form of ischemic stroke. There is still no definite recommendation for treatment. One of the considered and currently increasingly preferred options is intravenous thrombolysis. We present the results of a multicenter retrospective study to assess the safety and effectiveness of thrombolytic treatment in CRAO. Methods: All patients with CRAO from six centers who received intravenous thrombolysis were included in the retrospective study. The effectiveness of the intervention was evaluated in two stages. The first stage was when the residual vision in the affected eye was achieved at least to the level of the ability to orientate in space (recognizing contours). The second stage was the improvement of vision to recognize objects and faces. The effectiveness was further evaluated depending on the duration of the difficulties before the intervention. Safety was assessed based on the symptomatic intracerebral hemorrhage. Results: In the years 2016-2024, 32 patients (age 67.5 ± 12.9 years, 46.9% men) were treated for CRAO with intravenous thrombolysis.The median time from onset of symptoms to treatment was 6.5 hours. Within one year, 28% of patients had an ischemic stroke. Improvement after treatment occurred in 56.3% (1st degree - recognition of contours) and significant improvement in 34.4% (recognition of faces, ability to read). In patients treated within 4.5 hours, there was a significant improvement in 46%. In the case of treatment over 4.5 hours, there was a significant improvement in 26.3%. When symptoms lasted for more than eight hours, only 20% improved (at least partial improvement occurred in 46.7% of cases). Overall, intracerebral hemorrhage occurred in 6.3%. However, none of them were symptomatic. One patient had vitreous hemorrhage with subsequent correction of vision. Conclusion: CRAO is a significantly neglected subgroup of ischemic stroke. According to our data, intravenous thrombolysis is also an effective and safe therapy here.