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Monocytes infiltrate the brain post-stroke and differentiate into macrophages, which interact with microglia, astrocytes, endothelial cells, and neurons. These interactions, mediated by chemokines, cytokines, and extracellular vesicles, can be detrimental or beneficial depending on context. Another interface is the gut\u2013immune\u2013brain axis, wherein gut microbiota, immune cells, and central nervous system-resident populations engage in reciprocal communication. Emerging therapies targeting monocyte subsets, their recruitment, and communication pathways. These include preconditioned peripheral blood mononuclear cells, bone marrow-derived mononuclear cells, mesenchymal stem cells, and cell-free or cell-mediated approaches utilizing the secretome. Together, these interventions hold promise for enhancing stroke recovery by modulating the immune\u2013neural interface. This review summarizes recent advances in monocyte\u2013central nervous system communication and its translational potential in stroke.<\/jats:p>","DOI":"10.4103\/nrr.nrr-d-25-00738","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:00:26Z","timestamp":1761897626000},"page":"4674-4679","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Intercellular communication between peripheral monocytes and central nervous system cells in stroke"],"prefix":"10.4103","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6337-8156","authenticated-orcid":false,"given":"Masato","family":"Kanazawa","sequence":"first","affiliation":[{"name":"Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan"},{"name":"Department of Neurology, Brain Research Institute, Niigata University, Niigata, 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