Following studies that demonstrated the enormous benefits of endovascular treatment via catheter thrombus extraction in patients with large vessel occlusion, there has been huge interest in developing systems to identify patients who are endovascular candidates as early as possible in the pre-hospital setting. Since neuroimaging cannot be performed in the ambulance, clinical scales aimed at detecting patients with large vessel occlusion that are of great value bearing in mind that endovascular treatment is available only in certain comprehensive stroke centers. Therefore, access to endovascular treatment is currently limited, especially in more remote areas and intra-hospital transfers involve a delay that is difficult to shorten. In light of these factors, it is necessary to implement algorithms to shorten the time of revascularization treatment in acute stroke. A study was performed in Catalonia that found inequality of access to endovascular treatment in the different geographical areas of the region. Individuals who had direct access to comprehensive stroke centers received endovascular treatment more often and within a much shorter time than patients in more remote areas, especially if the journey time was more than 60 minutes. The endovascular treatment rate was between three and four times less for those treated in a center without endovascular facilities who subsequently required a second inter-hospital transfer. To minimize these differences, one example of a possible transfer algorithm would be to have patients with suspected large vessel occlusion transferred directly from the emergency medical services to an endovascular center, thus skipping the local hospital step. Although attending a local hospital can allow intravenous thrombolysis to be given earlier, in many cases a secondary transfer to an endovascular center is needed if the occlusion persists, which confers a certain delay due to the initial attention at the local hospital and the inter-hospital transfer. In an attempt to establish transfer algorithms, several pre-hospital scales have been created to identify patients with large vessel occlusion. These scales assess different times, although in general, they have all been demonstrated to have similar accuracy. However, few of these scales have been tested and validated in the pre-hospital setting and their use in everyday clinical practice is very limited. Recently, several international guidelines have set up proposals for transfer options for patients with acute stroke according to whether large vessel occlusion is suspected, so that patients who are candidates for endovascular treatment can get to endovascular centers as quickly as possible. These guidelines cite the Race Scale as a valid useful tool for the pre-hospital selection of patients who are candidates for endovascular treatment. For example, the American Heart Association has created a transfer algorithm based on the scoring on several pre-hospital scales. Among them the Race Scale in which they recommend transfer to a center with endovascular facilities, provided that the transfer is no more than 50 minutes longer than the transfer to the closest local non-endovascular center. In summary, there are few comprehensive stroke centers that can provide endovascular treatment and the time until starting treatment is crucial to obtain a clinical benefit. Therefore, identification of patients who are candidates for endovascular treatment is important to ensure their rapid transfer to a tertiary stroke center. The Race Scale is a valuable tool for pre-hospital care teams. It allows professionals to assess the severity of a stroke and detect patients who are likely to have large vessel occlusion.