Twenty six asymptomatic patients with internal carotid artery occlusion had ultrasound follow-up for a mean period of 34.3 months. During follow-up 3 patients (11.5%) reported transitory ischemic attacks (TIAs), one of these (3.8%) occurred in the vascular territory ipsilateral to the occlusion. There were not strokes. Annual TIA rate was 4% for all vascular territories, and 1.3% for the territory ipsilateral to the occlusion. Annual mortality was 9.4%. Our data on stroke risk in patients with asymptomatic carotid artery occlusion show a good prognosis in the long-term.