Summary:In the intradural proximal internal carotid artery aneurysms, various concepts and analyses have been proposed. In this paper, concept of the carotid cave aneurysms including anatomical consideration and surgical technique is described. When the carotid cave aneurysm is found after subarachnoid hemorrhage or incidentally, surgical treatment is usually advised. Regarding surgical management, the pterional approach is used with unroofing the optic nerve and removing the anterior clinoid process; the carotid artery mobilized and the clipping is performed with a ring clip with laterally curved blades.