Doppler sonography has gained considerable recognition as a noninvasive method of detecting carotid artery disease, and power Doppler sonography achieves good color-filling of all the examined vessels. Dolichoarterial disease of the internal carotid artery occurs in 10-25% of the population; these alterations are characterized by atypical elongation of the vessel, which predisposes it to tortuosity, coiling, and kinking, which is the most frequent morphologic anomaly and is characterized by sharp angulation (single and double Z-shaped). A patient with double Z-shaped angulation (kinking) of the left internal carotid artery was incidentally diagnosed in an asymptomatic state because of the broad use of these noninvasive investigations.