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23 patients were operated on between 3 and 24 hours (group 1) and between 2 and 14 days (group 2) after a stroke with a diagnosis of carotid obstruction. A retrospective study for patients of stage IIIa and IIIb showed that clinical and functional results of both groups correspond. The mortality of group 1 was slightly less than that of group 2. Group 1 showed the largest number of successful vascular reconstructions. Thus an early operation of stage IIIa and possibly IIIb seems indicated. In view of the high mortality (5 out of 6 patients) surgery cannot be recommended in stage IV.