In this study, trepanations in ancient Armenia are discussed. In total, 10 cases were studied. Seven were male, 1 female and 2 were children. Age of the individuals ranged from 6 to 65 years. Among nine cases of surgical trepanations four had possible healing signs. In these cases the individuals showed evidence of previous trauma to the skull or infection (mastoiditis, tuberculosis), suggesting that the operation had been carried out for therapeutic purposes. This provides further support for the suggestion that trepanation (or trephination) was performed primarily for therapeutic purposes, and because of cranial infection or injury. In one case, a symbolic trepanation could imitate real penetration into the skull cavity. This study shows that archaeological sites of Armenia and anthropological materials have a potential to supply essential information on ancient history of the Armenian people and the region.