Cerebrovascular disease in persons between 15 and 45 years of age is on the rise and represents a diagnostic challenge. With a thorough investigation, the cause of cerebral ischemic infarction or nontraumatic intracerebral hemorrhage can be identified in most cases and appropriate treatment can be administered. Subarachnoid hemorrhage is usually caused by ruptured saccular aneurysm, but misdiagnosis continues to be a problem. Angiography performed early in the course of illness is a safe diagnostic procedure in young adults with any type of cerebrovascular disease. Overall prognosis for young adults with cerebrovascular disease varies with the underlying disorder but is generally good.