Background Indications for patent foramen ovale (PFO) closure after ischemic stroke are primarily guided by the Risk of Paradoxical Embolism (RoPE) score and the PFO-associated Stroke Causal Likelihood Classification (PASCAL). Their application in routine care, however, is not well characterized. This study describes real-world management of patients with PFO presenting with ischemic stroke or transient ischemic attack (TIA). TIA cases were included to reflect clinical practice but are interpret