Objective：To employ the subtraction technique of 64slice spiral CT angiography for intra and extracranial arteries imaging, so as to study the managing method and assess the clinical outcome. Methods: The precontrast and postcontrast images of 100 patients were obtained by 64slice spiral CT angiography. A special head holder was used during the scanning to guarantee the accurate overlapping of the precontrast and postcontrast images. A reconstructed threedimensional model of the precontrast bone dataset was subtracted from the postcontrast dataset to produce the subtracted images. (1) An experienced operator performed the conventional and subtraction reconstructions; the periods for image generation of both methods were recorded and compared. (2) The quality of the images were evaluated and graded (grade 15) by 2 experienced radiologists in a doubleblinded manner. Results: (1) The new subtraction technique using 64slice spiral CT angiography needed significantly less time than the conventional method did (11.01±1.89 min vs 14.30±2.25 min，P<0.01). (2) The correlation coefficient of the results of 2 radiologists was 0.87. The score of image quality by subtraction 64slice spiral CT angiography was significantly higher than that by the conventional method (4.22±050 vs 2.93±0.36，P<0.05).Conclusion: Subtraction 64slice spiral CT angiography is easy to use and time saving for intra and extracranial artery imaging; it does not has the difficulty of separating artery from bone and is worth popularizing in clinic.