AIM: Intracranial hemorrhage during endovascular procedures is a devastating complication. It has high morbidity and mortality, being frequently treated with sacrifice of the ruptured vessel. Rescue strategies and techniques are required to improve outcomes. MATERIAL and METHODS: We present a case of a 60-year-old male presenting with symptomatic basilar artery stenosis due to atherosclerotic disease, refractory to maximal medical treatment, who underwent balloon angioplasty and suffered iatrogenic basilar artery hemorrhage. RESULTS: Hemorrhage control and vessel wall reconstruction were achieved with heparin reversal, intermittent balloon inflation, and telescoping stents. In addition, immediate external ventricular drainage was able to control the intracranial hypertension. CONCLUSION: The ruptured of intracranial vessels is usually challenging to treat. Intermittent balloon inflation with telescoping stents can help stop bleeding.