Cerebral revascularization is sometimes necessary in dealing with complex internal carotid artery (ICA) aneurysms.Mostly, ICA to middle cerebral artery (MCA) bypass or external carotid artery (ECA) to MCA bypass is the primary revascularization if sacrificing ICA is necessary.We presented two cases of complex internal carotid artery (ICA) aneurysms dealing with aid of superior thyroid artery middle cerebral artery (MCA) bypass.