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The management of pregnant patients with aneurysms represents a challenge. Vertebral aneurysms are an exceedingly rare condition. Their management is not defined due to the scarcity of cases. The best technique to reduce aneurysm rupture risk with simultaneous maternal and fetal wellbeing preservation is not established. The authors present a case of 41-year old pregnant woman, proposed for an elective cesarean section because of a previously described vertebral aneurysm waiting for repair after delivery. The concerns related to anesthetic management, including the advantages and disadvantages of general and neuraxial anesthesia in this specific case are discussed.