A case with a dissecting aneurysm of the intracranial vertebral artery is presented. The patient mainly presenting with lower nerve palsies, was treated by proximal ligation of the right vertebral artery. Cumulation of experience and a better understanding of the therapeutic modality of this pathology is needed since only 37 surgically treated cases with dissecting aneurysm of the intracranial vertebral artery have been reported in the literature.