A 43-year-old woman who was 12 weeks pregnant presented with a one-month history of visual loss in the right eye. Neuroimaging studies revealed multiple intracranial aneurysms, one of which compressed the right optic nerve. Her pregnancy raised many issues concerning her management. Evidence of aneurysm enlargement and the increased risk of aneurysm rupture as gestation progressed led to early, successful surgical intervention. © 1993.