A case of intracranial saccular aneurysm occurring in early childhood and presenting with sudden dysphasia and hemiplegia is reported. A review of the literature emphasizes the rarity of this lesion. Despite a significant preoperative neurological deficit, the patient tolerated ancurysm clipping and recovered well. The majority of reported cases involve males under 2 years old. Aneurysms in infants have a distribution different from that seen in adults. Microscopic examination of these lesions fails to show any evidence of inflammation or atherosclerosis. The data suggest that the pathogenesis of these rare childhood lesions differs from that of adult saccular aneurysms.