An otherwise healthy 30-year-old female patient presented to the referring hospital after experiencing a generalized epileptic seizure. The cranial CT scan showed dilated vessels and calcifications in the left temporo-occipital region without intracranial hemorrhage. She was referred to our center for further evaluation and treatment. A diagnostic cerebral angiography (DSA) found an arteriovenous malformation (AVM) in the left temporo-occipital region with a nidus of approximately 2 × 5 × 5 cm in size. The feeding vessels were terminal branches of the left middle cerebral artery (MCA) and the left middle meningeal artery (MMA), and venous drainage was via superficial veins to the transverse sinus and superior sagittal sinus. A varicose dilatation of a drainage vein suggested the presence of a fistulous arteriovenous (AV) connection in the angioma’s nidus. The patient was offered a hybrid multimodal treatment composed of preoperative embolization and subsequent microsurgical resection. For the entire treatment (endovascular and microsurgical), a 10% risk of a major complication with subsequent disability or death was estimated. After discussing other strategies—including conservative treatment and stereotactic radiosurgery—and their limitations, the patient agreed to the proposed multimodal approach. Under general anesthesia, the left temporo-occipital artery supplying the AVM was catheterized. Small platinum coils were released into the supplying MCA to prevent the liquid embolic material from later reaching the draining veins. Eventually, these coils were pushed into the nidus by the preferential blood flow and remained at the level of the arteriovenous junction, which significantly reduced the arteriovenous shunt. The subsequent injection of Glubran2/Lipiodol resulted in almost complete obliteration of the AV shunt with only minimal venous passage. Additionally, the transdural supply of the AVM from the left MMA was eliminated by Glubran2/Lipiodol injection. After this procedure, complete microsurgical resection of the AVM was achieved with less technical difficulty and reduced blood loss 1 day later, without significant intraoperative bleeding. Intraoperative indocyanine green videoangiography confirmed the absence of abnormal shunts. Both embolization and surgical procedures were tolerated without complications, and no further epileptic seizures occurred since surgery.