The introduction of high-field magnetic imaging (≥3 T) has made noninvasive arterial spin labeling (ASL) a realistic clinical option for perfusion assessment in vascular disorders. Combined with the advances provided by territorial imaging of individual intracerebral arteries and the measurement of vascular reactivity, ASL is a powerful tool for evaluating vascular diseases of the brain. This article evaluates its use in chronic cerebrovascular disease, stroke, moyamoya disease, and arteriovenous malformation, but ASL may also find applications in related diseases such as vascular dementia.