Ninety-five Japanese patients with Takayasu's disease were classified according to four patterns of severity of symptoms in the period from the onset of symptoms to diagnosis. Included were pattern A in 34 patients with a plateau course after the insidious onset of symptoms, pattern B in 18 patients with a decrescendo course after the sudden onset of severe symptoms, pattern C in 5 patients who had no severe symptoms during the years between the early and late periods of severe symptoms and pattern D in 38 patients with a crescendo course after the onset of symptoms and the following period of years of no severe symptoms. Fifteen patients died during the prospective follow-up period of 8.6 +/- 6 years (mean +/- SD) after admission, but 12 had had patterns C and D and the remaining 3 had had patterns A and B. The cardinal signs and symptoms are given in detail, particularly those at the onset. These data should aid in early diagnosis and prediction of the prognosis in Takayasu's disease.