Two cases of unruptured pial arteriovenous malformations (AVMs) presenting with intracranial hypertension and papilledema are reported. In the absence of previous hemorrhage or associated hydrocephalus, such a manifestation of pial AVMs is quite unusual. Both patients experienced prompt and sustained resolution of papilledema after surgical removal of the malformation. One case was complicated by the normal perfusion pressure breakthrough phenomenon postoperatively. The pathophysiology of intracranial hypertension associated with unruptured pial AVMs and the relationship to pseudotumor cerebri are discussed.