A comprehensive 30-year follow-up of 380,756 Swedish women revealed that assisted reproductive technology (ART) carries a 43% increased risk of cerebral ischemic conditions compared to natural conception among infertile women, but shows no elevated risk for heart attacks, heart failure, diabetes, or kidney disease. The supraphysiological estrogen levels induced during ovarian stimulation may contribute to this stroke-specific risk pattern. This finding fills a critical knowledge gap as ART usage continues expanding globally, with millions of procedures performed annually. The stroke risk translates to meaningful clinical implications given that cerebrovascular events can cause permanent disability. However, the study's observational design cannot establish causation, and residual confounding from unmeasured lifestyle factors remains possible. Importantly, infertility itself emerged as a broader cardiovascular risk marker, suggesting that reproductive health may serve as an early indicator of systemic vascular dysfunction. Since this is a preprint awaiting peer review, these findings require validation through independent replication before clinical practice changes. The research represents a significant advancement in understanding long-term ART safety, providing both reassurance for most cardiovascular outcomes while highlighting the need for enhanced stroke monitoring in ART patients.