Although it is controversial whether total occlusions of intracranial arteries can safely be opened by angioplasty, we treated six patients with total occlusions of the middle cerebral artery by percutaneous transluminal cerebral angioplasty (PTCBA) in the chronic stage after a stroke, on average 10 weeks. We successfully opened four total occlusions less than 3 months old, while two total occlusions more than 3 months old could not be opened. No complications occurred. Even in the chronic stage, PTCBA for total occlusion of intracranial arteries can be done safely.