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S.B. Ankara Eğitim ve Araştırma Hastanesi, Nöroşirürji Servisi, Ankara General approach to the bilateral aneurysm is treating first the bleeding artery then treating the aneurysm in the opposite site with a second craniotomy. In patients who have bilateral anterior circulation aneurysms, surgical clipping of all aneurysms via a unilateral approach would obviate the need for a second operation. The contralateral approach for aneurysm repair is technically feasible and safe method in appropriately selected patients.In case of contralateral approach, the characteristics like the condition of the brain, the length of the M1 segment, the size of the aneurysm, the presence of atheromatous plagues in the neck of the aneurysm and the experience of the surgeon plays important roles. In this report a case of middle cerebral artery aneurysm is presented, in which the neck was successfully clipped by way of a contralateral pterional aproach. Also, the superiority of this approach is emphasised. Anahtar Kelimeler : Aneurysm, Middle cerebral artery, Craniotomy, Case report, Intracranial aneurysm, Neurosurgical procedures