&NA;End‐to‐side, laser‐assisted vascular anastomosis (LAVA) using a Nd:YAG laser was successfully performed on rat carotid arteries. A midline neck incision allowed isolation and approximation of both carotid arteries in an end‐to‐side fashion using four 10‐0 nylon stay sutures. The laser parameters used for vessel fusion were 0.3‐second 5‐W pulses at a spot size of 600 &mgr;m. Anastomoses were analyzed at various time intervals from 1 day to 6 months by angiogram and histological examination. The anastomotic patency was 86%. Aneurysm formation occurred in 23%. Histological examination revealed an acute/subacute transmural injury both at the anastomotic site and several hundred microns away, with delayed re‐endothelialization and some attempt at muscular and elastic regeneration. Histological assessment of the aneurysms demonstrated a total loss of the internal elastic lamina and muscularis. A brief discussion comparing Nd:YAG LAVA to other LAVA techniques follows. (Neurosurgery25:584‐589, 1989)