The detection of intracranial AV-shunts may be difficult with non-invasive imaging. Due to the nature of spin-labeled protons, ASL-based MRA is likely to be highly specific for AV-shunting. We sought to determine the sensitivity and specificity of ASL-based MRA in a group of 32 patients, among those 14 with AV-shunts. Furthermore, the diagnostic performance for vascular pathology not associated with AV-shunting was assessed. We found ASL-based MRA to be more specific with an equivalent sensitivity compared to a clinical MRA-exam for intracranial AV-shunts. All vascular pathology not associated with AV-shunting were detected with ASL-based and clinical MRA.