Percutaneous transluminal angioplasty (PTA) for atherosclerotic lesions of the subclavian, vertebral, and brachiocephalic vessels is being performed in selected cases. Clinically patients presented with symptoms of vertebral basilar insufficiency, multiple transient ischemic attacks, subclavian steal syndrome, and motor weakness of the upper extremity. Thus far, 22 procedures have been performed with good results. This included 16 subclavian, 4 vertebral, and 2 innominate arteries. Follow-up has ranged from 8 to 26 months (mean 17 months). No permanent neurologic complications have occurred with this technique, and all patients had significant clinical and radiographic improvement following this procedure.