Cerebral arteriograms in 1,141 consecutive patients, which were done either as direct percutaneous carotid or brachial studies or as transfemoro-cerebral catheter studies, were reviewed. While the overall complication rate for the direct percutaneous studies was higher, the incidence of neurologic complications, both transient and permanent, was higher in the transfemoral group. This higher incidence of neurologic complications may be related to the frequent irrigation of the catheter, which increases the probability of embolism. The incidence of serious complications was lower than in previous studies, perhaps because gravely ill patients are more likely to undergo computed tomographic scanning.