Intracranial atherosclerotic disease accounts for 5–10% of ischemic strokes in the US. Lesions located in the anterior cerebral artery territory are infrequently reported. Patients in whom medical therapy fails are at a high risk for recurrent ischemic events, in which case intracranial angioplasty or stenting may be a reasonable therapy. There is a paucity of literature describing angioplasty of fixed atherosclerotic lesions affecting the anterior cerebral artery territory, and especially the A₂ segment. This case illustrates that this vessel segment may be treated with balloon angioplasty.