Objective : The present study was performed to assess intracranial vasculature involvement in patients with Behcet’s syndrome (BS) using transcranial color coded Doppler ultrasonography (TCCS). Findings will be correlated with the presence of neurovascular manifestations and other features of Behcet’s disease in the group of patients under study. Methods : The present study included 30 Egyptian patients with diagnosis of BS classified as group I. Twenty healthy controls were included representing group II to develop normal intracranial vascular sonographic ranges for comparison. Intracranial arteries of all patients and control subjects under study were investigated using TCCS. The patient group (Group I) was further divided into two subgroups ; group IA including 27 patients (90%) with abnormal intracranial vascular sonographic criteria and group IB including 3 patients (10%) with normal intracranial vascular sonographic criteria. Parameters of assessment included peak systolic velocity (PSV) and resistivity index (RI). Results : Abnormal laboratory work up, neurological and vascular involvement were more common in group IA compared to group IB. All other features of BS happened more commonly and severely in group IA except for ocular involvement which was more common in group IB. TCCS detected that 27 patients (group IA) had abnormal intracranial vascular sonographic criteria (90%) with only 44.4% of them having evident CNS involvement by clinical examination and other neuroradiological procedures. Abnormalities included increased PSV values which detects stenosis, decreased PSV values which signifies sluggish circulation and increased RI values which points to increased stiffness of vessel. In group IA correlating TCCS results to ages of patients, there was a significantly negative correlation between age and PSV values in left MCA and basilar artery. In group IA, mean PSV values were lower compared to group II except in LT MCA and in both PCAs. It reached a significantly lower level in left vertebral artery. In group IB, mean PSV values were lower than those of the control group (group II) in 45.5% of cerebral arteries examined. Significant lower level was detected in left vertebral artery. Mean RI values were higher in group IA compared to the control group (group II). A significant higher level was reached in the left MCA. Mean PSV values in patients not receiving immunomodulatory therapy were higher than those receiving it. Statistically significant higher levels were reached in both RT and LT vertebral arteries. Mean PSV values in patients not receiving anticoagulants were lower than those receiving them. Statistically significant lower level was reached in basilar artery. This signifies the role of both anticoagulant and immunomodulatory therapy in modifying neurovascular involvement and cerebral hemodynamics in BS. Conclusion : TCCS, which is an easy non invasive procedure, can be used for early detection of central nervous system involvement in BS patients, especially in neurologically asymptomatic ones. It can detect sluggish circulation in cerebral arteries of BS patients which denotes impaired cerebral perfusion. It also detects pathologicaly elevated PSV values i.e. stenosed arteries as well as increased RI for age which denotes premature stiffness of cerebral vessels. There is a progressive dilatation of cerebral arteries with age. This study also emphasized the role of immunomodulatory therapy in normalizing the increased PSV by modifying the immune mediated vasculitis. It also pointed out the effect of anticoagulant therapy in reversing the sluggish circulation and normalizing PSV by decreasing blood viscosity.