Giant and fusiform aneurysms of the basilar artery (BA) are difficult to manage surgically, and they still present a challenge for the neurosurgeon despite progress in posterior fossa surgery. Guglielmi detachable coils have provided an alternative approach to treatment, but they have their own difficulties. We present a series of three patients with BA aneurysms treated with endovascular occlusion of the aneurysm and basilar trunk. Our experience suggests that, in select cases, BA occlusion may be not only safe but also necessary for the effective treatment of these aneurysms.