Introduction <p>Pure arterial malformations (PAMs) are rare vascular malformations characterized by abnormally dilated, tortuous, and overlapping arteries that exhibit a coil-like appearance. These malformations are typically solitary. The occurrence of multiple separated PAMs is exceptionally rare. Here, we report these two cases.</p> Case Presentations <p>Patient 1 was a 52-year-old female who experienced subarachnoid hemorrhage. During a physical examination, the Hunt–Hess scale score was grade II. Computed tomography angiography revealed three aneurysms. In addition to these aneurysms, digital subtraction angiography (DSA) revealed the tortuosity of the left extracranial internal carotid artery (ICA) and anterior cerebral artery (ACA) and four PAMs of the anterior circulation. These three aneurysms all underwent treatment in stages. Postoperatively, the patient recovered well. Patient 2 was a 35-year-old female who fainted twice in 1&#xa0;month. During a physical examination, no positive signs were found. Computed tomography and magnetic resonance imaging showed the lesion in front of the brainstem. Magnetic resonance perfusion imaging did not reveal significant hypoperfusion of the bilateral cerebrum or cerebellum. On DSA, the bilateral extracranial ICAs were tortuous. One small and one large fenestration were identified in the right ACA and anterior communicating artery. Three PAMs of the posterior circulation were confirmed. Conservative treatment was provided due to the mild symptoms.</p> Conclusions <p>These two cases substantiate the congenital pathogenesis of multiple separated PAMs: the first case manifested concurrent multiple intracranial aneurysms with extracranial/intracranial vascular tortuosities, whereas the second case demonstrated extracranial ICA tortuosities coexisting with arterial fenestrations.</p>