It is common belief that there is a relatively low incidence of cerebral aneurysm in the Middle East; however, there are neither routine autopsy studies nor reliable public health data to confirm this impression. We analyzed the clinical data of all patients admitted with a diagnosis of nontraumatic subarachnoid hemorrhage to the King Faisal Specialist Hospital, a modern tertiary medical center in Riyadh, Saudi Arabia. These data were compared with reports from other countries. Although environmental or inherited factors may predispose to a lower incidence of intracranial aneurysm in the Middle East, the true incidence is higher and is not apparent because of the previous referral system for medical care. Medical facilities and expertise are rapidly improving, and future studies undoubtedly will show a higher incidence of intracranial aneurysm.