The anterior cerebral artery (ACA) can be defined as two main parts by the anterior communicating artery (ACoA): the horizontal part/the precommunicating segment and the vertical part/the postcommunicating segment. The bilateral ACAs run in parallel in the interhemispheric fissure beyond the ACoA, providing the advantage of an intracranial (IC)-IC bypass pattern to aid the other if one is occluded or has to be sacrificed. There are various technical options for ACA revascularization, including reanastomosis, in situ bypass, reimplantation, and bypass with short interposition grafts.