Abstract: Objective To discuss perioperative nursing of adult ischemic moyamoya disease patients who underwent direct and indirect vascular reconstruction.Methods 20 patients with is-chemic moyamoya disease received health education,psychological intervention and sufficient pre-operative preparation before operation.Postoperative situation and complications were observed carefully,and the guidance of diet and exercise were given to the patients.Results 18 cases re-covered without serious complications.ipsilateral cerebral infarction in large area found in one case, contralateral cerebral infarction in large area happened in one case,and they recovered well after ac-tive treatment and careful nursing.Conclusion Direct combined with indirect vascular reconstruc-tion is an effective method in the treatment of ischemic moyamoya disease,positive and effective perioperative nursing can help operation effect,reduce the occurrence rate of complications and pro-mote recovery of patients.