Stent thrombosis is a severe complication associated with percutaneous coronary interventions (PCIs). The optimal treatment strategy of this complication is not well known, although emergency PCI in hospitals with 24 h facilities for urgent coronary angiography is still considered the best solution. The present report descibes four cases of subacute and late stent thrombosis treated with systemic thrombolysis due to the unavailability of the catheterization laboratory. All patients had a very short symptom-to-treatment time (median of 50 min) and were successfully treated with tenecteplase. The subsequent coronary angiography confirmed complete resolution of the thrombosis and the patients were discharged without further PCIs performed.