The purpose of this study is to elucidate the prevalence and degree of occlusive lesions of carotid and intracranial arteries in patients with symptomatic lacunar infarction. We performed carotid and intracranial MR angiography, and T2-weighted MRI on 65 patients with symptomatic lacunar infarction. Stenosis of more than 25% narrowing of the diameter was found in 12 patients (18.5%) in the extracranial carotid arteries and in 14 patients (21.5%) in the intracranial arteries. Most of the stenotic lesions were mild. Multiple logistic regression analysis showed that age was significant and independent predictor for carotid artery stenosis, and that diabetes mellitus was predictor for intracranial artery stenosis. The incidence of intracranial artery stenosis was statistically higher in patients with asymptomatic lacunar infarctions in subcortical white matter area on T2-weighted MRI than in patients without such lesions. Coexistence of carotid artery stenosis should be suspected in aged patients with symptomatic lacunar infarction, and the possibility of intracranial artery stenosis should be considered in patients with diabetes mellitus or asymptomatic lacunar infarctions in subcortical white matter area.