Ultrasonic Doppler studies were made pre- and postoperatively in 22 patients undergoing STA-MCA anastomosis. A quantitative evaluation of the bypass was attempted by determining the STA blood flow velocity and pattern. The STA velocity on the Doppler sonogram was compared with the degree of intracranial vascular filling via anastomotic channels and the STA diameter on angiogram. The STA velocity was increased and the blood flow pattern of STA altered from an external carotid pattern to an internal carotid pattern in a patent bypass. The results were in good agreement with angiographic findings. The are of intracranial vascular filling via a vewly formed bypass on angiogram was proportional to the increase in STA velocity. As the STA diameter enlarged, the STA velocity increased progressively. It is suggested the Doppler flowmetry is reliable as a semi-quantitative means of evaluationg the STA-MCA anastomosis.