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Background and Aims Management guidance for MoyaMoya Disease (MMD) recommends estimation of cerebrovascular reserve (CVR) to guide decision making around revascularisation surgery. CVR can be measured by ultrasound, CT perfusion scan (CTP), and radionucleotide scanning. At our centre CRV is assessed using CTP with Acetazolamide challenge. We assessed if CRV measured by CTP scanning correlated with demographics, vascular risk factors and ongoing symptoms at time of scanning.Methods Retrospective cohort study of patients with MMD/MoyaMoya Syndrome (MMS) who had CTPs at a UK tertiary neurology centre between December 2014-2024.Results 31 patients (Male=10, Female=8) were identified. The mean age at diagnosis was 39 years. CVR was rated ‘normal’ in 16, ‘abnormal’ in 15. Female sex (p=0.006) and history of TIA/Ischaemic stroke (p=0.013) were significantly associated with abnormal CTP. There was no significant association between recurrent symptoms, migraine, intracranial haemorrhage, age at diagnosis, seizure, hypertension or smoking; and abnormal CTP.Conclusions There was an association between Sex and History of TIA/Ischaemic stroke with CTP outcome. Our analysis was limited by small sample size; further research could help develop clinical tools to predict cerebrovascular reserve.john.williamson5@nhs.net