A retrospective chart review of 435 consecutive intracarotid amobarbital tests (IAT) was performed to determine the frequency of carotid artery dissection (CAD) associated with IAT. Three patients with a CAD were found (0.7%). Mean age of patients with dissection (51.3 years) was higher than the average age of 432 patients without dissection (31.7 years) (p < 0.05). All patients had clinical symptoms including face or neck pain. Patients undergoing the IAT are at risk of CAD. Age may be a risk factor.