Sixty three cases of anterior cerebral artery aneurysms observed in the period of 1960-1972 were reviewed on basis of their surgical approaches. The authors claim the necessity to perform intracranial vessels arteriography only in alert patients, except when haematoma is to be suspected. The surgical procedure consists in a frontal triangular craniotomy, followed by a subfrontal approach to exposing the aneuysm. Superior posterior implan- tantion of the aneurysmal sac may require partial ablation of the girus retus. In the same way continuous cerebrospinal fluid drainage facilitates the approach, as the arterial hypotension enables a safer neck dissection. Only clippsing and wrapping techniques are now employed. The rate mortality was 50% between 1960 and 1967, 18% in the period 1967-72 and 16% in 19 cases operated in the last two years.