Rupture of intracranial vessel during general anesthesia dramatically jeopardise patient's state and may lead to death. A sudden cardiovascular change during intubation and extubation in general anesthesia is dangerous, especially in patient with coronary and intracranial vascular disease. Myocardial infarction, congestive heart failure or intracranial hemorrhage can occur in such condition, but these occur rarely. We discovered the rupture of the hidden intracranial arteriovenous malformation in 13 years old female patient after tonsillectomy. We discuss about prognosis, prophylaxis and management of the intracranial arteriovenous malformation rupture during general anesthesia.