Smoke disease is a progressive occlusive cerebrovascular disease characterized by bilateral narrowing or occlusion of the internal carotid artery and the anterior and middle cerebral arteries with smoke-like vascular formation. In layman’s terms, it is a large tree with a thick trunk that breaks off and a cluster of tiny branches grows directly and locally, looking like a cloud of smoke. Smog can cause cerebral ischemia, mostly in pediatric patients, and cerebral hemorrhage, mostly in adult patients, with ventricular hemorrhage being the most common, and can bleed again at intervals. For patients with ventricular hemorrhage, drainage or conservative treatment is indicated depending on the amount of hemorrhage. Later, direct, indirect or combined revascularization may be performed to improve cerebral hemodynamics and reduce smoke vascularization to prevent recurrent stroke. The most commonly used direct revascularization is superficial temporal artery-middle cerebral artery bypass, and the commonly used indirect revascularization includes superficial temporal artery-brain patch, temporal muscle-brain patch, superficial temporal artery-temporal muscle-brain patch, and cranial multi-point drilling, all of which have certain effect. In young people, non-hypertensive ventricular hemorrhage, don’t forget to check for smoldering disease.