We reported here a patient of moyamoya-like disease with repetitive limb-shaking TIAs on drinking. Regional cerebral blood flow (rCBF) was quantified with and without drinking by single photon emission computed tomography with intravenously injected N-isopropyl-p-(I-123) iodoamphetamine (IMP). RCBF was reduced by alcohol ingestion. We speculated that homodynamic TIAs might be caused by impaired autoregulation in the region of the left carotid artery.