Forty-four unselected patients with amaurosis fugax (AF) have been followed for 4.6 years (mean 2.6). Thirty per cent had atheromatous lesions, 20% had miscellaneous diagnoses (temporal arteritis 5, transitory ocular hypertension 2, glaucomatous iritis 1, benign intracraniel hypertension 1), 50% consisted of young, mainly women, in whom no cause was found. Prior to AF 2 had hemiplegia, 4 TCI, one optic atrophy and suspicion in 3. None died, one developed hemiparesis and one macular degeneration. An individual conservative attitude to AF seems justified in this material.