The authors report the case of a 38-year-old patient who presented with a ruptured anterior spinal artery aneurysm confirmed by MRI. This patient harbored neurological deterioration related to a rebleeding at Day 1. Control angiography showed spontaneous occlusion of both aneurysm and distal anterior spinal axis. Expectative strategy was finally chosen because of the rebleeding. However, these spinal aneurysms must be treated urgently because of the risk of ultra-early rebleeding.