The efficacy of emergency surgical interventions on the carotid and vertebral arteries in patients with acute disorders of cerebral circulation is discussed. An organizational structure of rendering aid is suggested, which unites emergency ambulance service, neurology, and vascular surgery in one therapeutic institution. A clinical classification of the severity of acute cerebral ischemia and the optimal terms for operations were elaborated. In a group of 21 patients who underwent emergency operations 14 showed excellent and good clinical results.