Brief introduction. It is very important to identify Transient ischaemic attacks (TIAs) promptly because of the very high early risk of ischaemic stroke. It requires urgent investigation. TIAs have many clinical situations and diagnosis as mimics. TIA is a common diagnostic challenge at the pre-hospital stage. Materials and methods. Aim of this study was toevaluateTIA mimics at the pre-hospital stage in Latvia. This observational and retrospective study included all consecutive adult patients with prehospital diagnosis of TIA (G45 by IDC-10) referred to five hospitals in Latvia during 12 months. Referrals were considered correct if the prehospital diagnosis of TIA matched with the hospital discharge diagnosis. Results. In total, 2874 patients were included in our study. The prehospital diagnosis of TIA was correct in 14.4% cases. The most frequent mimics were vertigo (517, 17.9%), stroke (364, 12.7%), blood hypertension (295, 10.3%). In total there were 235 different hosptial discharge diagnosis. Conclusions. Transient ischaemic attacks have a high rate of mimics at prehospital stage in Latvia. The accuracy of prehospital diagnosis with hospital dicharge diagnosis is very low (14.4%). The most frequent mimics are vertigo, stroke, blood hypertension (40.9% combined). TIAs are a serious diagnostic challenge at the prehospital stage.This indicates that in Latvia there is a room and need for improvement at the prehospital TIA identification methods. [ABSTRACT FROM AUTHOR]