We have had the opportunity to investigate a case with traumatic middle cerebral artery occlusion. The patient was 47 years old male who developed right hemiplegia and aphasia after collision with a automobile vehicle. Cerebral arteriography demonstrated complete occlusion of the left Sylvian middle cerebral artery distal to the origin of the operculofrontal arteires. The computed tomographic scan of the brain revealed dense infarction on the left temporoparietoccipital lobe. With repeated studies on 6 weeks and 6 months after trauma, confirmed partial clearing of the previously occluded middle cerebral artery in cerebral arteriographies and on interval change in computed tomographic scans. Comparable reported cases and theories of pathogenesis are discussed.