The purpose of this study was to introduce our initial experience of using hybrid microsurgery and intravascular surgery for treating complex cerebral aneurysms (ANs) and arteriovenous malformations (AVMs). The hybrid surgery included a single operative intervention of microsurgical partial neck clipping (neck plasty) followed by coil embolization for patients with ANs and strategic intravascular embolization after craniotomy followed by removal for patients with AVMs. Intraoperative microcatheter 3D-angiography, ICG videoangiography, Doppler sonography, and electrophysiological monitoring were all routinely used. Total obliteration of the lesion was achieved in all patients without significant morbidity. The hybrid suite is a useful setup which allowed for an unconstrained combined microsurgical and neuroradiological workflow. Our initial experience introduces hybrid surgery as a safe and more durable treatment option for the management of complex intracranial ANs and AVMs.