We report four young women with Takayasu's arteritis who developed an ischemic stroke. In three of these patients, this complication heralded the onset of the disease. Three patients also had seizures. In all cases, the diagnosis was suspected on the basis of an abnormal cardiovascular examination showing absent carotid or radial pulses, carotid bruits or significant asymmetries in blood pressure determinations. The aortogram showed that three patients had Takayasu's arteritis type I, with affection confined to the aortic arch and supra-aortic trunks, and the other patient had Takayasu's arteritis type III with additional involvement of the descending aorta. Three patients had an elevated erythrocyte sedimentation rate and were treated with corticosteroids. Takayasu's arteritis should be suspected in young patients, especially women, presenting with a cerebral infarct or seizures who also have an abnormal cardiovascular examination. The diagnosis is usually confirmed by aortography, following Ishikawa's diagnostic criteria. Corticosteroid therapy may be of value in patients with an elevated erythrocyte sedimentation rate.