The incidence of aneurysms coexisting with arteriovenous malformations (AVMs) ranges between 2.7 and 16.7%. The anatomical relationship between the AVM and the aneurysm is critical in deciding the best management. As a broad guide, this relationship can be classified as follows: 1) aneurysms unrelated to the AVM; or 2) aneurysms located on the feeding vessels to the nidus, which may be far away from the nidus or close to it or even within the nidus itself. Although radiosurgery has been widely accepted as a method of choice for AVM treatment, the role of radiosurgery for arterial aneurysms has not been adequately discussed.