Introduction: The complexity of an intracranial aneurysm is defined by its location, size, previous treatment, presence or absence of collateral circulation, intraluminal thrombus, or calcification of the aneurysm wall. The treatment of these aneurysms must be based on the balance between the associated risks and the benefit for the patient; Within microsurgical techniques, the extradural minipterional approach is described.

Clinical case: a 33-year-old female patient who presented headache, vomiting, and sensorial disorder, being diagnosed with 2 complex aneurysms, one in the ruptured ophthalmic segment and the other in the unruptured right pituitary. She underwent an extradural minipterional craniotomy plus aneurysm clipping with complete occlusion and a favorable outcome.

Conclusion: The knowledge of new microsurgical techniques in the management of complex cerebral aneurysms is crucial to obtain satisfactory results, being the extradural minipterional approach an alternative and key approach for the treatment of these lesions, which represent a challenge for the neurosurgeon.