The persistence of embryonic carotid-basilar and carotid-vertebral anastomoses was investigated retrospectively in 4,400 cerebral angiograms. Six primitive persistent carotid-basilar anastomoses and one primitive persistent carotid-vertebral anastomosis were found. In 4,400 cerebral angiograms, the incidence of primitive carotid-basilar and carotid-vertebral anastomoses was 0.14% and 0.023% respectively. Primitive persistent anastomoses are associated with intracranial vascular anomalies, especially aneurysms. The clinical and pathological findings in combination with these primitive persistent anastomoses were also examined.