Of 1,042 persons examined at autopsy, 376 cerebral lacunes were found in 114. The lacunes were studied in regard to incidence, number, location, and size. Most frequently involved in descending order were the lenticular nucleus, pons, thalamus, caudate, and internal capsule-corona radiata region. A relationship of lacunes to hypertension and cerebral atherosclerosis has now been amply confirmed. Lacunes were not related to internal carotid artery disease, cerebral embolism, or diabetes. In these cases in which the patient was admitted to the general medical wards there was usually no history of a stroke and, if there was, a good clinicopathologic correlation was impossible becuase of incomplete details, as well as the multiplicity and complexity of the lesions found at autospy (infarction and hemorrhage). In this series, advanced pseudobulbar palsy and dementia were apparently these signs in the literature has probably been the result of studying specially selected cases. The responsible arterial lesion can at present only be surmised, and there is a need for further studies of the vascular process.