Intravenous digital subtraction angiography (IV-DSA) and subsequent conventional selective carotid angiographic examinations were reviewed in 78 patients who were suspected of having cerebrovascular disease, and the results were correlated with surgical findings in 53 patients. The impact of the information provided by each of these examinations on subsequent therapy was reviewed. IV-DSA examinations of acceptable quality accurately depict atherosclerotic lesions in the cervical carotid arteries. We found IV-DSA to be deficient for detection of intracranial vascular disease.