Arteriovenous malformations (AVMs) are vascular lesions consisting of arteries connected to veins with an intervening nidus, composed of abnormal thin-walled vessels instead of capillaries. These high-flow lesions can become symptomatic by rupturing and causing intraparenchymal and subarachnoid hemorrhage, seizure, neurologic deficits, etc. AVMs may be treated using conservative observation, radiation therapy, endovascular embolization and surgical extirpation as stand-alone or combination therapies. In this chapter endovascular embolization and surgical interventions are discussed. A thorough history and proper examination of these lesions will help to choose the best treatment approach for the patient. Surgical approaches are used to minimize brain retraction and iatrogenic injury. Cure of AVMs after endovascular embolization alone is rare but due advances in technology, (such as detachable tip microcatheters and improved embolic agents) may help to improve its safety and efficacy.