Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the left temporal M2 branch. A step-by-step operative description, with emphasis on proper microsurgical technique, is included. Eric J. Arias, M.D.1 and Gregory J. Zipfel, M.D.1,2 Departments of Neurological Surgery1 and Neurology,2 Washington University School of Medicine, St. Louis, Missouri