The incidence of aneurysms of the distal cerebral artery (DACA) has been reported at 2 to 4%. In this paper we report a series of 12 patients with DACA aneurysms diagnosed at various hospitals in the San Francisco area during the past 10 years. The clinical presentation, surgical approach, and anatomical location are reviewed. Comparisons are made between traumatic, mycotic, and berry DACA aneurysms.