Angiography has a defined role in the management of vascular or neurologic diseases with less emphasis on screening and diagnosis and greater emphasis on pretherapeutic evaluation and endovascular treatment. This is especially true in diseases in the external carotid circulation. Advances in catheter technology and super-selectivity have improved our understanding of the anatomy and hemodynamics in normal and pathologic states. The functional neurovascular anatomy of the external carotid artery and diseases in which angiography has a role are reviewed.