Cerebrovascular disease remains a central subject in neurology, and this issue of Neurologic Clinics features cutting edge articles regarding preoperative and perioperative treatment of this disabling disorder. Topics include carotid artery stenting versus carotid endartectomy, intracranial vessel stenting, surgical intervention for intracranial aneurysms, clipping versus coiling of intracranial aneurysms, and choice of neuroimaging in perioperative acute stroke management.