Background: Neurosurgical intervention and endovascular manipulation of middle cerebral artery (MCA) needs more information about the anatomy of its different segments specially its proximal one. 
Aim of the work: Is to assess different morphological and morphometric measurements of the proximal segment (M1) of MCA in Egyptians. Also, is to evaluate clinical significance of such variations. 
Patients and methods: This research was carried out retrospectively on three dimensional magnetic resonance angiography images of eighty healthy individuals without any cerebrovascular abnormalities. The morphological variations as well as measurements (the lengths and diameters) of M1 were evaluated. Side and sex differences as well as correlation between different parameters were also done.
Results: There was only statistically significant sex difference regarding M1 length on right side. In addition, there was significant positive correlation between different measurements of M1 of MCA regarding side. M1 branches were mostly bipode and least quadripode on both sides. The division of M1 was observed more frequent distal to genu and less frequent proximal to genu on both sides. At transverse plane, high percentage of concave posterior course of M1 was seen in 52.5% and 55% of cases on right and left sides, respectively. While concave anterior course of M1 was least noticed in 13.8% and 10% on right and left sides, respectively. Early cerebral artery (ECA) was found in 65 % of studied cases.
Conclusion: The anatomical variations results of M1 of MCA as evaluated by 3D-MRA are very useful for neurosurgical approach.