Due to its extraordinary height, the giraffe experiences great cardiovascular challenges both in the upright position and when the head is lowered to drink. When assuming the drinking position, the giraffes makes a ~4 m vertical change in head position within a second and arterial pressure at the level of the head is expected to increases some 250 mmHg. This increase is considered to outrange the cerebral autoregulation and should therefore, at least potentially, lead to cerebral edema and eventual hemorrhage. After drinking (water) the giraffe is able to lift the head back to upright position in one consecutive movement without showing signs of dizziness. We measured pressure and flow along with vessels diameter and spinal fluid pressure in the neck of 5 anaesthetized spontaneously breathing giraffes, suspended in upright position while changing the head position. When the giraffes head was lowered to heart level, the mean arterial pressure (MAP) and central venous pressure (CVP) decreased while spinal fluid pressure increased. The jugular vein was distended and a total of ~1.2 l of blood accumulated in the veins when the head was lowered. When the head was raised, the jugular vein collapsed and blood was returned to the central circulation, restoring CVP and MAP. The study support that in the upright standing giraffe cerebral blood flow is governed by arterial pressure without support of a siphon and that blood accumulates in the vein when the head is lowered.