Takayasu's disease is an unusual arteritis that affects young females. Stroke is a common presenting symptom usually due to sudden occlusion of one or more thoracic aortic arch arteries. The author recommends prophylactic bypass of involved aortic arch arteries to prevent strokes. Abdominal aortic involvement causes severe claudication of the lower extremities which can be treated by bypass originating from the thoracic aorta. Involved upper extremity arteries should be bypassed for ischemic symptoms for accurate blood pressure measurement to diagnose and treat hypertension. Renal artery involvement is common and best treated by percutaneous transluminal angioplasty. Surgical results are excellent with minimal morbidity and mortality. Anastomatic complications such as false aneurysms are unusual although anastomatic stenoses do occur.