The expanding availability of digital subtraction angiography has essentially contributed in lowering the risks in the use of angiography of the cerebral arteries. The best results in imaging the cerebral artery are achieved by conventional subtraction angiography after selective catheterisation. This is, however, only important for diagnosis in intracerebral pathological changes distal of the Circulus Willisi or in connection with preoperative interventional radiological treatment. Pre-clinical diagnosis of patients with cerebrovascular occlusive disease as well as clinical diagnosis with Doppler and B-scan US sonography can be optimally complemented by DSA using 4-5 French catheters entered in the thoracic ascending aorta. Using this technique, the sensitivity and specificity with an image-matrix of 512 is diagnostically adequate and includes an only limited examination risk. Complication with lasting neurological defects will be least observed after intravenous pre-atrial application of contrast media and most after selective angiography of the carotid artery. Here the extent of the multiple arteriosclerotic obliteration is of essential importance. The quality of interpretation of the diagnostic findings essentially depends on indications not only about the grade of obliteration but also on the morphological details. At present DSA with application of contrast media into the thoracic ascending aorta in combination with the duplex-scan method represent the optimum for the diagnosis of cerebrovascular disease. In spite of lower specificity intravenous application of contrast media has to be preferred for post-operative controls and controls of progressing disease with "screening".