Perioperative ischemic stroke is one of severe perioperative complications, affecting the patient's quality of life and prognosis. We reported a case about acute ischemic stroke following thoracoscopic lung resection in day surgery center. This 56-year-old male patient had hyperlipidemia but no other underlying cardiovascular diseases. 15 hours after surgery, the patient experienced sudden weakness in his left upper limb. He was treated with emergency endovascular thrombectomy, supported by a multi-disciplinary team. The patient was discharged 35 days after the operation, showing significant improvement in left upper limb function. This case highlights the need for heightened vigilance for perioperative ischemic stroke, even in patients considered to be at low risk in day surgery center, prompting reconsideration of screening of patients for day surgery and anesthesia management.