At the Honolulu Heart Study 7,895 men of Japanese ancestry, 45--68 year-old, who were free of previous stroke at the baseline examination (1965--1968) were followed 6 years for the development of transient cerebral ischemic attacks (TIA). Fifty-one men developed probable or possible episodes. In multivariate analysis TIA was associated with preceding hypertension, cigarette smoking and coronary heart disease. It was less common in men who were facile with written Japanese language, in those who consumed alcohol, and in those who were physically active. During an average follow up of 3 years after these TIA events 2 strokes occurred, vs 0.7 expected. This prognosis is more favorable than that reported by other studies.