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Arteriovenous malformation (AVM) combined with aneurysms is not uncommon, but AVM of the basilar artery, brainstem, and right middle cerebral artery combined with multiple intracranial aneurysms (IAs) is rare. Cases of aneurysm protrusion into the optic canal are also rare. We report a distinctive case of intracranial AVM combined with multiple IAs and partial protrusion of a cavernous segment aneurysm of the right internal carotid artery into the optic nerve canal. Teaching Point: Cases of partial protrusion of a cavernous segment aneurysm of the right internal carotid artery into the optic canal, resulting in widening of the optic canal compared to the contralateral side, compression, thickening and swelling of the subocular veins, and obstruction of venous drainage warrant the clinician’s attention.