Aim: This technical report illustrates the potential of photon-counting computed tomography angiography (PCCT-A) in detecting small, incidental intracranial aneurysms, which are often missed by conventional imaging. Material and Methods: We present the case of a 60-year-old male patient who underwent PCCT-A following a routine cranial CT. The imaging was performed using a NAEOTOM Alpha scanner (Siemens) with 70 mL of iodinated contrast. The scan protocol included 0.6 mm slices, 140 kV, and a 5 mL/s injection rate. Results: PCCT-A revealed a previously undetected 1.5 mm saccular aneurysm at the bifurcation of the left middle cerebral artery (MCA). The lesion was not visualized with prior MR angiography. Given its small size and favorable morphology, conservative management with follow-up was chosen. The case demonstrates PCCT’s superiority in spatial resolution, tissue contrast, and artifact reduction, enabling clearer detection of subtle vascular anomalies. Conclusion: This case highlights PCCT-A as a promising non-invasive alternative to 3D rotational DSA in the evaluation of small intracranial aneurysms. With improved diagnostic capability and lower radiation burden, PCCT-A may redefine standard protocols in neurovascular imaging. Further studies are warranted to validate its utility in routine clinical practice.