In a series of 250 intracranial arteriovenous malformations (AVM's), 12 malformations involved the brain stem. Nine of these lesions were treated surgically, with complete obliteration in eight. There were no operative deaths, and only two patients were made worse by surgery. In the nonsurgically treated group, one patient had embolization therapy and two patients underwent radiation therapy. Results in these three patients have not been satisfactory. These data indicate that brain-stem AVM's can be surgically removed with acceptable morbidity.