In the current pandemic situation, a better understanding of the pathophysiological mechanisms associated with COVID-19 and characterization of cerebrovascular pathologies and outcomes is critical not only to estimate the risk but also to guide decision making. We present a case series of COVID-19 patients from two different health systems presenting with acute cerebrovascular pathologies. We also reviewed the literature to present a comprehensive summary of the SARS-CoV-2-induced factors that are associated with acute cerebrovascular pathologies. In addition, we performed a pooled analysis of published data on large vessel occlusion strokes in the setting of COVID-19.