Thirty-five carotid endarterectomy patients and 17 peripheral vascular surgery controls were evaluated psychologically preoperatively and postoperatively. The endarterectomy sample was restricted to patients with transient ischemic attacks. Neuropsychological tests included measures of language, attention, memory, problem solving, and sensory and motor skills. Personality tests included measures of general psychopathology, with specific evaluation of anxiety and depression. Mean scores of the endarterectomy and control groups were not statistically significantly different preoperatively for any test. Postoperatively, only the endarterectomy group showed mean improvement on measures of memory and verbal fluency. Both groups showed improvement on several other neuropsychological measures, and in reduction in state anxiety and on another indicator of psychopathology. Endarterectomy patients whose cognition improved postoperatively were younger, better educated, and had lower admitting systolic blood pressure; they also tended to have a lesser incidence of generalized vascular disease.