Résumé : BACKGROUND:: Posterior circulation fusiform aneurysms (PCFA) are rare but difficult to treat. OBJECTIVE:: To report our experience with endovascular treatment (EVT) of PCFA. METHODS:: A retrospective review of our prospectively maintained database identified all PCFA treated by endovascular approach over a 6-year period. Clinical charts, procedural data, and angiographic results were reviewed. RESULTS:: From March 2004 to March 2010, 31 patients were identified including 11 asymptomatic patients, 9 who presented with a subarachnoid hemorrhage (SAH), 6 with a stroke, and 5 with a mass effect. All but one patient - who died before being treated - were successfully treated (97%) by parent artery occlusion (n=10), stenting + coiling (n = 10), or stenting alone with conventional or flow-diverter stents (n=10). Twenty-two patients showed a good or an excellent outcome (73%), 3 had a fair or a poor outcome (10%), and 5 patients died (17%). These later 8 patients initially presented with severe SAH or mass effect. There was no definitive procedure-related morbidity or mortality. Immediate aneurysm occlusion was incomplete in 20 cases (67%) and complete in 10 cases (33%). Mean follow-up of 20 months in 23 patients showed 12 further thrombosis, 9 stable results, and 2 flow reductions. Final results included 19 complete occlusions (83%) and 4 incomplete occlusions (17%). CONCLUSION:: PCFA may be treated by different endovascular approaches with satisfying clinical and anatomical results in most cases. However, patients who present with severe SAH or mass effect have still a poor prognosis.