Purpose — to evaluate the advantages and disadvantages of a mini-approach for performing EC-IC bypass. Material and methods. The mini-approach was used in 35 patients (32 males and 3 females) with symptomatic occlusive lesions of the brachiocephalic arteries (BCAs) who were treated at the Department of Vascular Neurosurgery of the Federal Center of Neurosurgery in Novosibirsk in the period between January and December 2014. The mini-approach was performed through a skin incision of up to 5.5 cm in the donor artery projection. The approach was planned based on comparison of the MSCT-angiography data. Results. In all cases, the mini-approach enabled performing EC-IC bypass in the optimal location, with the minimal involvement of the donor artery and the minimal size of craniotomy. Complications (shunt thrombosis) in the early postoperative period occurred in 3 (8.5%) cases. There were no cases of marginal wound necrosis. The mean bed-day was 7 days. Discussion. We analyzed the literature regarding using the mini-approach in combination with various mapping variants based on neuroimaging data. Conclusion. The approach has a high potential for wide application in clinical practice. The disadvantage is the narrowness and depth of the surgical wound, which complicates manipulations when performing EC-IC bypass and requires special skills.