Exercise is a uniquely effective and pluripotent medicine against several non-communicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared to traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimise health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This talk will critique the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. The objective of this talk is to highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimise exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the ageing brain have the potential to prevent stroke and associated neurovascular diseases.