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Conventional continuous oxygen therapy primarily increases systemic oxygen availability, but may be insufficient to restore impaired cerebrovascular responsiveness, while excessive or prolonged oxygen exposure may increase oxidative stress and attenuate adaptive oxygen-sensitive pathways. In this review, we propose programmed oscillatory oxygen therapy (POOT) as a treatment-design framework for dynamic oxygen modulation after ischemic stroke. Rather than treating oxygen solely as a metabolic substrate, POOT reframes oxygen as a dynamic biological signal that may engage hypoxia-inducible factor, reactive oxygen species, nitric oxide, and related oxygen-sensitive pathways to support cerebral blood flow regulation and neurovascular coupling. Unlike fixed intermittent hypoxia, intermittent hyperoxia, or hypoxia\u2013hyperoxia training protocols, POOT is proposed as a parameter-explicit and potentially feedback-informed framework targeting post-recanalization microvascular dysfunction. 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