Aneurysmal changes were studied by light and electron microscopes in experimental monkeys to elucidate their pathogenesis. Early changes were found not at the medial defect but in one branch near the apex. Degeneration of the elastic lamina was always more than that of the media throughout the process of aneurysm formation. Endothelial injury was present even at the bifurcation without a bulge. The present study suggests that aneurysmal changes are initiated by degenerative changes in the endothelium, which are followed by alterations in the underlying elastic lamina and, in turn, in the medial layer.