Background: There are some case reports that distal stump of the occluded cerebral artery mimics aneurysm, which were proved by following cerebral angiography or by during operation finding. Case Report: A 35-year old man admitted due to acute left basal ganglia infarction. Initially radiologist reported that the brain MRA showed an incidental finding of an aneurysm in the right middle cerebral artery (MCA) bifurcation. However, when we reviewed his old brain MRA taken three years ago, there was focal stenosis in the one branch of the right MCA trifurcation. We concluded that focal stenosis of the MCA branch had been progressed to occlusion and a proximal stump of the occluded branch mimicked cerebral aneurysm. Conclusion: We must pay attention to MCA branch occlusion similarlooking cerebral aneurysm and vice versa for proper diagnosis and preventing unnecessary procedure.