Smoker’s disease is a condition in which a brain angiogram reveals a fuzzy mesh-like shadow at the base of the brain due to abnormal capillary proliferation, which resembles a puff of smoke from smoking, hence the name. Since the lesions of smog are all within the skull, whether it is a narrowing and occlusion of blood vessels or a malformation of the vascular network at the base of the skull, it is invisible to the naked eye. MRA can detect smog, but the results are not very accurate because the resolution is too poor. At present, DSA is the gold standard for the diagnosis of smog, which can reflect the morphological structure of cerebral blood vessels in a comprehensive manner with clear images and high resolution, providing realistic three-dimensional images for the observation of vascular lesions and the localization and measurement of vascular stenosis. The narrowing or occlusion of the main branches of the cerebral arterial ring bilaterally and the abnormal smoke-like network of tiny vessels at the base of the skull can be seen on DSA images, thus providing an accurate scientific basis for treatment. After examination, if a patient is diagnosed with smog, surgery should be performed as soon as possible, because conservative medical methods have been proven to be of little significance in the treatment of smog, and surgery is the only way to treat smog. The combined vascular bypass surgery is an advanced and effective treatment modality, which can establish a perfect blood supply channel for smog patients and improve the blood supply to a large extent through direct and indirect intracranial and extracranial vascular anastomosis. This technique was introduced by Prof. Jin from Japan in the early years, and later improved and enhanced by Prof. Jin’s expert team clinically to make its effect more and more remarkable.