Duplication of vertebral artery is a very rare finding. Here, we present a case of vertebral artery duplication, cervical vertebral artery aneurysm and multiple intracranial aneurysms in a 59-year-old woman. This is the first case of vertebral artery duplication with cervical vertebral artery and intracranial aneurysms. © 2009 The British Institute of Radiology.