A 54-year-old man experienced a right occipital headache accompanied by a roaring sound, nausea, vomiting, right facial weakness, and stiff neck. Vertebral angiography revealed an aneurysm of the right anterior inferior cerebellar artery (AICA) at the internal acoustic meatus which was later excised with favorable results. The literature is reviewed; operations have been reported in eight other cases. Inconstant waxing and waning cerebellopontine angle symptoms and signs can be found when a history of subarachnoid hemorrhage is lacking.