Basilar artery perforator aneurysms are very rare and usually present with subarachnoid hemorrhage. High-quality imaging systems with digital subtraction angiography and three-dimensional rotational angiography are crucial for the detection of these posterior circulation vascular lesions, which may still be missed on the initial angiogram. We present the first use of a Flow Re-Direction Endoluminal Device (Microvention, Aliso Viejo, California) for treatment of a ruptured basilar artery perforator aneurysm via snuffbox vascular access and use of cangrelor for antiplatelet management.