Smoker’s disease is a relatively rare cerebrovascular disease that was first identified and named by Japanese medical experts in the 1950s and 1960s. The name of the disease is based mainly on the morphology of the patient’s cerebral angiogram. It is called smoky disease because of the chronic progressive narrowing or occlusion of the major arteries in the brain, which leads to the formation of an abnormal network of small blood vessels at the base of the skull, resembling smoke exhaled during cerebral angiography. Smog can occur in all age groups, from 60 to 70 years old and down to 2 years old. However, the age of onset of smog is bimodal, with adults in their forties and children under the age of ten being the main focus. If left untreated, the consequences can be very serious, causing motor impairment, sensory impairment, visual impairment, speech impairment, mental retardation, etc., and may even lead to disability and death. Therefore, smog should be treated promptly (both in children and adults) to avoid irreversible symptoms. The medical community recognizes that once a diagnosis of smog is made, surgery should be performed as soon as possible, and that conservative treatments are not very useful. So some people ask, can children with smog disease be minimally invasive? In fact, the treatment of smog disease requires craniotomy to perform cerebrovascular bypass and patch surgery to reconstruct cerebral blood flow channels and improve cerebral blood supply to achieve the treatment purpose. This is not considered minimally invasive surgery, but it is not very invasive and allows for a quick recovery through close and systematic perioperative management.