The middle cerebral artery has been noted to demonstrate anomalies less frequently than the other major intracranial arteries. The cerebral angiograms and brief case histories of 7 patients with anomalies involving the middle cerebral artery are presented. Three cases of accessory middle cerebral artery, 2 cases of duplication of the middle cerebral artery, and 2 cases of early bifurcation of the middle cerebral artery are reported.