Objective To determine the clinical features and the efficacy of joint use of direct and indirect revascularization surgery for ischemic moyamoya disease.Methods To improve cerebral blow flow,combined with superficial temporal artery-middle cerebral artery anastomosis and encephalo-duro-arterio -myo-synangiosis (STA-MCA + EDAMS) in 34 ischemic moyamoya disease patients.Results During follow-up period,with no cerebrovascular event happened.2 patients suffered transient ischemic attack (TIA).1 suffered slight cerebral infarction and 1 intracerebral hemorrhage events (ICH),both of them were happened on the operated hemisphere.7 patients suffered temporary neurological deterioration due to cerebral hyperperfusion after operation.Conclusions Direct and indirect revascularization surgery were safe and effective treatment for moyamoya disease,although the issue of postoperative cerebral hemorrhage and cerebral hyperperfusion complications of the procedures remained to be solved.