A giant intracranial aneurysm is known to have a natural history of high rupture rate which leads to significant morbidity, mortality, and health care costs [1,2]. High complication rate has been reported with both surgical and endovascular treatment [3-5]. Pipeline embolization device (PED) use in giant intracranial aneurysms has become increasingly established for treatment in many of these cases as retrospective and prospective studies demonstrates lower overall procedural cost and higher efficacy and safety protecting the parent artery [6,7]. However, the treatment of giant aneurysms remains a formidable challenge due to technical aspect of PED placement. Giant aneurysms could have strong inflow jets, which is reported a link between vertical flow and rupture status as well as technical challenge to direct microcatheters over wires into the parent artery across an aneurysmal. In many cases, this procedural step can be prohibitively difficult due to the aneurysm inflow jet sucking microcatheter over wires into the aneurysm and precluding access to the parent artery distal to the aneurysm. We report on the first case of a transient proximal flow arrest technique to prevent inflow jets in order to cross the neck of a giant intracranial aneurysm to facilitate PED placement.