Sixteen patients with acute occlusion of the basilar artery were treated with systemic fibrinolysis. Recanalisation was achieved in 10 patients; five patients survived and 11 patients died. Survival was associated with vascular recanalisation in every case. Most of the survivors were younger than 50. An age above 50 and a comatose state on admission seem to indicate a poor clinical outcome. The problem of multimorbidity in the older age group also affects outcome adversely. Haemorrhagic complications were found in two cases (12.5%), with clinical deterioration in one.