Transient ischemic attacks (TIA) were observed in 17.5% of patients (40/227) before lacunar infarction (LI) in a consecutive clinical series. Approximately half of these patients (47.5%) had multiple episodes; most of them (89.5 %) were clinically stereotyped, and the median duration was 30 min. The average latency between the last episode and the LI was 24 h, and 72 h between the first episode and the LI. In comparison with TIA associated with ischemic infarctions in the middle cerebral-artery area (IMCA), TIA in LI presented (1) a lower frequency of episodes (17 versus 38%, p < 0.001); (2) a higher number of multiple episodes (47.5 versus 27%; p < 0.05); (3) a longer duration of neurological deficit (p < 0.002), and (4) a shorter latency between the last episode (p < 0.0001) or the first episode (p < 0.02) and the definitive ischemic stroke. Our results show that TIA associated with LI have some distinctive clinical features and some different semiological characteristics in comparison with TIA associated with IMCA.