Objective　 In order to observe the long-term follow-up of 72 patients with transient ischemic attack（TIA），including the recurrence of TIA after the first attack, occurrence of complete stroke and myocardial infarction, fatality rate, causes of death, and the survival rate in each year and its 95% confidence interval, and to evaluate the clinical significance of neurovascular surgical indication.　Methods　 Seventy-two patients with TIA collected from 1959 to 1977 were followed up by means of face-to-face communication with the patients themselves or their families till 1998. And those aspects mentioned above were analyzed with the methods of cohort study, life table and other medical epidemiological statistics. 　Results　 The recurrent rate of TIA in 72 patients was 27.9%, and the occurrence rate of complete stroke 65.7%, and that of the myocardial infarction and the fatality 8.4% and 72.7%, respectively. There were 2(3.8%) patients died of myocardial infarction. It was showed from the study that the main cause of death was complete stroke, accounting for 59.6% of all dead patients, with the first cause in non-elderly patients was cerebral hemorrhage and that in the elderly patients was cerebral infarction. The 20-year survival rate was 39.9% and its 95% confidence interval was (28.4%，51.4%). Nineteen cases had the indication of neurovascular surgical operation, accounting for 26.6% of all 72 patients. 　Conclusions　 In the long-term follow-up study, the prognosis of patients with TIA was better than that of those with cerebral infarction. About one third of patients had the recurrence of TIA. The occurrence rate of the complete stroke was obviously higher than that of the myocardial infarction. It was considered that neurovascular surgical operation for preventing the happening of complete stroke in patients with TIA was limited.