In this case report, a 49-year-old woman developed subarachnoid hemorrhage in the right cerebellopontine angle cistern and blood into the fourth ventricle from a ruptured peripheral aneurysm of the anterior inferior cerebellar artery (AICA) located at the meatal loop. Concomitantly, a contralateral peripheral aneurysm was found in the posterior inferior cerebellar artery (PICA). A second peripheral aneurysm, not identified by previous angiography, was found in the caudomedial branch of AICA. We describe this diagnostic dilemma, management, and review the clinical presentation and location of 84 other peripheral AICA aneurysms reported in the literature.