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SSK Okmeydanı Eğitim Hastanesi, Nöroşirürji Kliniği, İstanbul Vertebral artery fenestrations or segmental duplications originate from vascular anomalies during the embryological development of the vertebral artery. Fenestration of vertebral arteries refers to a division of an artery, resulting in two distinct endothelium-lined channels, which may or may not share their adventitial layer. Fenestration of vertebral artery is seen rarely and can be found with vascular anomalies like aneurysms or arterovenous malformations. In this report, intracranial left vertebral artery fenestration associated with left middle cerebral artery aneurysm is presented with the relevant clinical and radiological procedures. Anahtar Kelimeler : Aneurysm, duplication, fenestration, vertebral artery