A total of 254 patients who were proved to have pontine high intensity areas on T2-weighted magnetic resonance imaging (MRI) were analyzed in relation to brainstem semiology. A comparative study on MRI and MR angiography was made between 254 patients with pontine high signals and 276 control cases showing no abnormality either on T1 or T2-weighted images. Of the 254 patients, 62 had transient subjective complaints such as vertigo-dizziness. Supratentorial high signals, basilar artery tortuousness and vertebral artery asymmetry on MR angiography were seen more frequently in patients with pontine high signals than in the controls. In conclusion, pontine high signals may be resulted from diffuse arteriosclerosis and MR angiography is considered to be a useful screening method.