Interventional neuroradiology—a relatively new medical subspecialty known also as endovascular neurosurgery—treats cerebrovascular, head and neck, and spinal disease by using minimally invasive techniques. Interventional neuroradiology was originally developed in the 1980s by neuroradiologists and neurosurgeons. Since that time, dramatic advances in interventional neuroradiology have been made possible by similarly rapid advances in medical technology, such as neuroimaging (particularly digital subtraction cerebral angiography and angiographic road-mapping), and development of revolutionary medical devices. Many medical conditions which could not be treated effectively 15 years ago can now be treated curatively using current endovascular techniques. Indeed, even within the field of interventional neuroradiology, new technology and devices introduced within the past five years have allowed interventional neuroradiologists to increase the number of life-threatening cerebrovascular diseases which can be treated effectively. Emergence of interventional neuroradiology has marked a transition from the radiologist's traditional role as a consultant: Interventional neuroradiologists serve not only as consultants but as clinicians who assume an active role and responsibility in treatment. This article provides a brief overview of the historical basis for interventional neuroradiology, current treatment options for different types of cerebrovascular disease, and anticipated future developments in the field. This article also discusses current status and future plans for the Interventional Neuroradiology program at Kaiser Permanente (KP) Medical Center in Redwood City, California.