A 38-year-old man was hospitalized complaining of an episode of syncope. He was diagnosed with acute infective endocarditis (IE) of the aortic and the mitral valves with mobile and large vegetations, complicated with mycotic cerebral emboli related to the left anterior and the middle cerebral arteries. Double valve replacement with mechanical prosthesis was performed within 24 hours after cerebral accident occurred. On the 36 postoperative day, emergency cerebrovascular surgery was done due to rupture of a mycotic intracranial aneurysm. He was discharged on foot without any neurological abnormal finding. The optimum treatment of IE complicated with cerebral embolism is a controversial theme. Management should be considered carefully in individual cases.