The purpose of this article is to provide an overview of all aspects concerning interventional neuroradiology of vascular central nervous diseases. Today, interventional neuroradiology can help many patients that, even until a few years ago, did not have any possibility for a safe cure. Complex cerebral arteriovenous malformations and fistulas, inoperable aneurysms and intravascular thromboses are often treated with interventional neuroradiology alone, while in other cases a combination of neurosurgery and radiation may help in reaching a good outcome for the patients. In the past few decades the efforts by neuroradiologists and collaborating clinicians to develop treatment strategies and methods for these and other high-risk diseases represent a vast, fascinating field of modern medicine. The article therefore focusses on the state-of-the-art and describes presently used methods for diseases that can be treated with interventional neuroradiology. Literature dealing with the historical development of interventional neuroradiology and important publications of recent scientific work are reviewed, providing the reader with an overview of the most pertinent material on each disease discussed. Aspects of training and ethics are discussed and emphasis is focussed on the importance of recognizing these aspects as essential in any case of interventional radiological treatment.