To evaluate the influence of age on carotid atheroma we reviewed the angiographtc findings in 120 patients with reversible ischemic attacks. The prevalence and severity of atherosclerotic lesions increased significantly with age, and this difference persisted after adjusting for hypertension. These results may at least partly explain the poor long term prognosis for elderly subjects with reversible ischemic attacks, and underscore the importance of taking age into account when relating clinical and angiographic findings in patients with cerebrovascular ischemia. (Stroke1987;18:43–45)