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Zhejiang Provincial People’s Hospital, Department of Neurosurgery, Hangzhou, China DOI : 10.5137/1019-5149.JTN.9152-13.1 Although intracranial multiple aneurysms are not uncommon, multiple mirror aneurysms are relatively rare. A few isolated cases have been described. However, to the best of our knowledge, 3 pairs of pure symmetrical mirror aneurysms in one patient have not been reported yet. We present a case of multiple mirror aneurysms involving the bilateral middle cerebral artery (MCA) bifurcations and posterior communicating arteries (P-com A) confirmation by one-stage operation. The possibility of one-stage treatment must be considered before surgery. Missed diagnosis and misdiagnosis must be avoided before one-stage operation for multiple mirror aneurysms. Keywords : Multiple intracranial aneurysm, Mirror aneurysms, Subarachnoid hemorrhage (SAH), Preoperative evaluation, One/multiple stage treatment