Pathologic studies of women with fatal cerebrovascular disease who have received oral contraceptives are infrequently found in the literature. Three cases of this type are reported here. The pathologic findings included an intrinsic vascular lesion in the form of intimal hyperplasia with and without associated thrombosis, found in arteries supplying the brain. Similar vascular lesions have been reported previously in other sites of the vascular system in association with exogenous or endogenous steroids. They have also been found in other species under the influence of steroids. This hyperplasia of vessel intima may be found in association with other clinicopathologic entities, but stigmata of other diseases were not found in these three patients.