To describe the strategies and techniques to improve the outcomes in intracranial hemorrhage during endovascular procedures, a case of a 60-year-old male with symptomatic basilar artery stenosis who underwent balloon angioplasty procedure following an iatrogenic basilar artery hemorrhage, is presented. 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. In conclusion, the ruptured of intracranial vessels is usually challenging to treat. Intermittent balloon inflation with telescoping stents can help stop bleeding.