Giant intracranial aneurysms are not uncommon, accounting for about 5% of all intracranial aneurysms, however, giant aneurysms of the posterior inferior cerebellar artery (PICA) are quite rare. PICA aneurysms, comprise 0,5-3% of all aneurysms. Distal PICA aneurysms constitute 15% of them. Rarely, they manifest the clinical signs of a posterior fossa mass lesion.The authors present a case of giant PICA aneurysm. It was successfuly excised without any neurological deficit.