Complete bilateral carotid artery occlusion in a young adult is unusual and, to our knowledge, it has not been previously reported. The patient had been receiving oral progestational agents for nine months prior to the onset of occlusion which produced clinical manifestations of a decerebrate state. Bilateral carotid angiography demonstrated bilateral carotid artery occlusion. At autopsy, arteriosclerotic plaques were found in the completely occluded carotid vessels. Hypercoagulability of the blood associated with the use of oral contraceptives and the arteriosclerotic plaques were probably the etiologic factors in producing the occlusion.