We observed three patients with isolated retinal arterial aneurysms and obtained a clinicopathologic correlation in one of them. All three were hypertensive and in the sixth or seventh decade of life. Fatty exudates were present around the aneurysms, taking the form of large circinate rings in two cases. Microscopic examination in one case revealed a retinal arterial aneurysm with an extensive fibroglial reaction around it. Dilated capillaries, hemosiderin deposits, and both lipoidal and proteinaceous exudates were found in the adjacent retina. Isolated retinal arterial aneurysms appear to be distinct clinical entity as compared to miliary aneurysms of the cerebral circulation.