Differences in the clinical presentation and angiographic stages of moyamoya disease were studied in 69 patients, 35 children (6.3 ± 2.9 years old) and 34 adults (44.6 ± 10.5 years old). The angiographic stage (Suzuki''s stage) was compared between childhood and adulthood, ischemic onset and hemorrhagic onset, and female and male. The distribution of the angiographic stage was not very different, but was significantly shifted from stage III to stage IV in adult cases. The angiographic stage in patients with hemorrhagic onset was not significantly different from those with ischemic onset. There was no significant difference between females and males. Angiographic change is not very remarkable between pediatric and adult moyamoya disease. The angiographic stage does not directly correlate with the distinct clinical presentations between pediatric and adult moyamoya disease. Other factors such as cerebral blood flow demand and arteriosclerotic change seem to cause these differences.