In Takayasu disease, the aortic arch, with its main arterial trunks and the descending aorta, as well as renal arteries, is the main site of inflammation. Takayasu disease is thought to begin clinically with symptoms of systemic inflammation or with eye symptoms. Cerebral vascular disease is usually a consequence of severe hypertension, or carotid or brachiocephalic obstruction. Recently, it has been emphasized that use of Doppler ultrasound, computed tomography angiography, and positron emission tomography (PET) scan, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in combination, may facilitate the detection of Takayasu disease activity at a more treatable stage. Concerning the treatment and management of Takayasu disease patients with stroke, one has to consider the treatment of Takayasu disease and stroke separately. Subclavian steal syndrome or moderate carotid stenosis, as well as renal artery stenosis may be an indication for angioplasty and/or stenting.