Twenty-one previously reported cases of aneurysms of the anterior inferior cerebellar artery (AICA) were reviewed. They often present acutely with subarachnoid hemorrhage due to rupture, or less frequently with an insidious onset, as a cerebellopontine angle (CPA) mass. Rupture of the aneurysm is usually not difficult to diagnose because of the acute symptoms and the subarachnoid hemorrhage, which can easily be detected by CT or lumbar puncture. However, caution must be exercised in those lesions presenting as a CPA mass clinically, which on CT appear unusually dense with contrast enhancement. Erosion of the internal auditory canal may be present but is non-specific. If an enhancing CPA mass appears atypical and dynamic CT confirms rapid enhancement, vertebrobasilar angiography is essential to establish an AICA aneurysm as the cause.