The double origin of the posterior inferior cerebellar artery (PICA) is a variant anastomosis of a residual lateral spinal artery and native intracranial PICA that has been associated with intracranial aneurysm formation. Because of this anastomosis, both origins of the PICA serve as aneurysmal-feeding vessels. We describe a novel technique of coiling with intracranial stent assistance to treat such a lesion that has not been described previously to our review.