Objective To analysis the clinical characteristics and to evaluate the diagnostic value of total cerebral angiography in adult Moyamoya disease.Methods The clinical characteristics and DSA materials of 6 patients with adult Moyamoya disease were retrospectively analysed.Results First symptoms were cerebral ischemia and first diagnosis were cerebral infarction occurred in the all patients,in which conventioanl neurological treatments were unable to show any efficacy and the true diagnosis of Moyamoya disease was build up.The stenosis of occlusion with different extents of the bilateral internal carotid arteries and collateral circulations were shown in total cerebral angiography.Conclusion Interventional radiologist should master the clinical characteristics of adult Moyamoya disease patients and its apperance of total cerebral angiography so as to make them receive positive diagnosis and treatment as far as possible.The total cerebral angiography is still a golden standard to diagnose Moyamoya disease.