An uncommonly recognized complication of neurofibromatosis (NF) is an angiopathy of the intracranial and extracranial arteries. Most of the previously reported cases have presented as an occlusive process similar to Moyamoya disease. We present our experience over the past 3 years involving three patients with five cerebral aneurysms and associated NF. Four of the aneurysms were intracranial, two being fusiform in nature. Treatment was surgical occlusion and included Selverstone clamping, balloon occlusion, and direct clipping. There appears to be an association between the development of cerebral artery aneurysms and NF, but the pathophysiology of these vascular changes is not fully understood.