Blunt cerebrovascular injuries are uncommon but potentially devastating injuries that can lead to stroke and death. While uncommon, appreciation of the seriousness of these injuries, a high index of suspicion in high risk patients, and aggressive screening of multitrauma patients leads to early diagnosis of asymptomatic lesions that may be amenable to treatment prior to the onset of ischemia. The radiologist can play a vital role in the early diagnosis, follow-up, and, in some cases, treatment of these challenging injuries.