Seventeen patients with arteriographic findings consistent with the carotid "string" sign are presented. Five separate clinicopathologic categories were present, and each required special consideration for proper management. The arteriographic findings alone were insufficient to allow categorization or to predict intraoperative findings. Special emphasis is placed on the importance of examining the apparently occluded carotid artery for signs of the carotid string sign which, if found, indicates continued patency. Familiarity with the broad spectrum of clinicopathologic entities associated with the carotid string sign facilitates management of these often complicated problems.