We report a case of a ruptured aneurysm of the anomalous cerebellar artery originating from internal carotid artery presenting with a carotid cavernous fistula (CCF). An initial angiogram showed the typical appearance of a CCF with a direct fistulous tract with focal aneurysmal dilation from the ascending cavernous segment of the right internal carotid artery. A postembolization angiogram of the right internal carotid disclosed the anomalous cerebellar artery originating from the fistula point of the internal carotid artery.