Cerebrovascular occlusive disease is one of the important causes ofcerebral ischemic injury. We have attempted through our essay todefine the physiologic and pathophysiologic mechanisms involved inischemia due to occlusive cerebrovascular disease.We have also attempted to define the clinical manifestations andinvestigative techniques involved in investigating the patients andselecting the best surgical candidates.We have also defined various surgical procedures involved inaugmentation of cerebral blood flow in such patients as well as thesurgical technique, pre and postoperative managements and possiblecomplications.