The accuracy, and possible clinical application of non-invasive ultra sound imaging of the cervical carotid, artery in patients with cerebrovascular disease has been investigated by comparing a pulsed multi-channel directional Doppler imaging devise (“MAVIS” - GEC Medical) with conventional carotid angiography. Of 23 normal or minimally diseased internal carotid arteries only 4 appeared as stenosed on Doppler angiography, the other 19 were normal; of 14 stenosed arteries only 1 appeared normal on imaging,1 appeared occluded end 12 showed clear images of stenosis; all 6 occluded arteries appeared occluded on ultra sound imaging. It was difficult to obtain satisfactory images of the external carotid arteries in all cases. The additional facility to display a velocity flow profile at preselected points along the arterialimage should increase the usefulness of this technique, particularly when there is only minor atheromatous irregularity or ulceration, and such a device will be briefly disrussed.