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Background: Small deep infarcts called 'lacunes' classically have been diagnose by autopsy. Since l970s we can diagnosed small deep infarcts easily as a result of the development of neuroradiologic diagnostic methodology such as CT or MRI. Now lacunar infarcts became to be one of the most common subtypes of stroke. Small deep infarct is a small artery disease of brain that is caused by obstruction of small perforating arteries(diameter 50-200um) by lipohyalinosis and microatheroma etc. Diabetes mellitus can cause small vessel arteriopathy, especially in the retina, kidney and might therefore be a risk factor for cerebral small vessel disease and lacunar infarction. Method: We conducted a retrospective study to show the clinical mamfestations, frequently-involved sites, risk factors of small deep brain infarction. The subjects were the patients diagnosed as small deep infarct/ischemia or lacunar infarct on brain MRI during 1993. Results: 1) Mean age of the subjects is 62.7 years old and mean symptom-onset age is 60.6 years old. Fifteen percent of them were below 50 years old and most small deep infarcts developed after fifties. 2) They were presented most commmonly as stroke (45%), and then vertebrobasilar insufficiency(9.4%), memory disturbance or multi-infarct dementia(8.8%), Pakinson's disease(4.1%), TIA(1.7%). 3) Small deep infarcts were located in the periventricular white matter(79.7%), basal ganglia(58.1%), pons(29.4%), thalamus(28.1%), cerebellum(15%). 4) The main risk factors identified in these patients were hypertension(69.8%), previous TIA or stroke history(36.1%), diabetes mellitus(32.4%), obesity(32.1%), smoking(27.8%), hypercholesterolemia(13.8%), coronary artery disease(11.1%), atrial fibrillation(5.7%). Symptom-onset age was negatively correlated with diastolic blood pressure(r=-0.40, p=0.01) and frequencies of previous TIA or stroke positively correlated with number of risk factors(r=0.45. p=0.001). 5) There were no differences in the clinical manifestations, locations, risk factors between diabetics and non-diabetics.