Objective: A series of 2086 patients with cerebral arteriovenous malformations (AVMs) were reviewed and 635 patients underwent surgical treatment after 1992. Clinical characteristics and surgical results of patients with cerebral arteriovenous malformations (AVMs) were assessed. Methods: Collected data of 2086 consecutive AVM patients from January 1956 to October 2001 were analyzed. The size of the AVMs ranged from 1 to 9 cm. Patients who underwent surgical treatment were divided into two groups by date of admission: one was from 1992 to 1996 and the other was from 1997 to 2001. The variables assessed for clinical characteristics in our study included: age (at diagnosis), sex, Spetzler-Martin grade, first presentations. The surgical results were assessed by comparing the surgical complications between the two surgical groups. Difference between the two groups was assessed by chi(2) test. Results: Cerebral AVMs are more commonly diagnosed at age 20 to 40 years. Hemorrhage (43.4%), headache (24.9%), and seizure (17.3%) were the first three common presentations. There was no difference in age distribution and sex ratio between the two surgical groups. Regarding Spetzler-Martin grading system, the percentage of grade 3 to 5 patients increased while that of grade 1 and 2 patients decreased (P=0.00). But the incidence of main surgical complications (death, hemiparalysis, cranial nerve dysfunction and gastrointestinal hemorrhage) was the same (P=0.796). Conclusions: Cerebral AVM is one of the important reasons for spontaneous intracranial hemorrhage in young patients. Spetzler-Martin grading system is helpful to predict the surgical risk. Microsurgical technique has made surgical treatment safer and become the best choice for cerebral AVM patients. Combination of intraoperative embolisation with surgical resection is a practical method in the treatment of giant cerebral AVMs. (C) 2003 Elsevier B.V. All rights reserved.