Cerebral arteriovenous malformation (AVM) is a bunch of structural variants of the arteries and veins intertwined together in the vascular mass, between the arteries and veins to form one to several fistulas without capillaries, the blood can be arterial fistula through the arteriovenous fistulas straight into the veins, and then back to the venous sinus, this abnormal cerebrovascular structure and cerebral blood flow changes can lead to cerebral hemorrhage, cerebral blood theft and so on and cause a series of cerebral dysfunctions, and therefore, it is important to carry out active treatment. Therefore, active treatment is necessary. According to the different levels of AVM, individualized treatment plans are formulated, and various methods combining embolization, radionurosurgery and microsurgery are adopted. Together with appropriate perioperative treatment of Xiong Hui, Department of Neurosurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, most of the cerebral AVMs can be treated with good therapeutic effects. I. Microsurgery To date, surgical resection of cerebral AVM is still the most ideal treatment for this disease because of its rapid efficacy and high cure rate. However, the higher the grade of AVM, the higher the risk of surgery, so it is necessary to grasp the appropriate indications for surgery and the timing of surgery. The key lies in choosing a good surgical indication. The authors usually follow the following principles: (1) AVMs with a history of intracranial hemorrhage and Spetzler grading of 1 to 3.5, except for lesions involving the hypothalamus, brainstem, and other regions, are feasible to be surgically resected; (2) without a history of intracranial hemorrhage, the lesion is located in a superficial nonfunctional area with a diameter of less than 3 cm, and surgical resection is preferred; (3) without a history of intracranial hemorrhage, but there are intractable epilepsies uncontrolled by medications, and resection of the lesion may be helpful to control seizures; (4) In the acute phase of intracranial hemorrhage, the advantages and disadvantages of performing cerebral angiography should be weighed. In general, the incidence of recent rebleeding of AVM is low, and most patients with bleeding without brain herniation crisis should have cerebral angiography to understand the full picture of AVM after conservative treatment of hematoma without change and stabilization of systemic symptoms, and then selectively undergo resection of the lesion. However, when intracerebral hematoma leads to cerebral herniation crisis, craniotomy should be performed immediately to remove the hematoma, and lesion resection should not be performed blindly without angiography.