Anterior cerebral artery is one of the most common sites for intracranial aneurysms. Anterior communicating artery is the commonest site for anterior cerebral artery (ACA) aneurysms, representing about 35% of all intracranial aneurysms. Twenty cases of ACA aneurysms were included in this study. All cases were treated by microsurgical clipping. Early securing of the aneurysms and nimodipine treatment reduce the incidence of rebleeding as well as delayed ischemic neurological deficits. The most commonly used surgical approach to these aneurysms is pterional trans-sylvian approach, craniotomy is usually performed from the right side.