Aneurysm at the distal portion of the anterior inferior cerebellar artery (AICA) is uncommon and only 55 cases have been documented in the literature. Here we report an additional three cases with review of the literature. All three patients presented with subarachnoid hemorrhage. The ruptured aneurysms were located at the meatal loop of the AICA in all three patients and one patient had another unruptured aneurysm at the lateral branch distal to the meatal loop. Two patients underwent surgical trapping of the aneurysms, and the other patient was treated with endovascular coiling because of poor clinical condition. Increase of hearing disturbance was found in two patients who underwent surgery or endovascular coiling, respectively. Clinical features and treatment of these rare lesions are discussed with reference to the 7th and 8th nerve impairments as preoperative symptoms and postoperative complications.