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Background Flow diversion has become an important approach in the management of intracranial aneurysms. Nevertheless, its safety and effectiveness concerning distal middle cerebral artery (MCA) aneurysms have not been thoroughly examined. This study seeks to update and consolidate the existing literature by assessing occlusion rates, procedural complications, and clinical outcomes associated with flow diversion in this subset.Methods A systematic review and meta-analysis were carried out in accordance with PRISMA guidelines. Relevant studies published up to 2026 were identified by searching major databases using set criteria. A random-effects meta-analysis using R (version 4.4.2) was conducted to evaluate pooled rates of occlusion and complications. Heterogeneity was measured utilizing I 2 statistics, and publication bias was checked through funnel plots.Results 10 studies involving 128 distal MCA aneurysms treated with flow diverter stents were included in the review. The aggregated complete occlusion rate was found to be 87% (101/120; 95% CI: 80%-93%), with no significant heterogeneity noted (I 2 = 0.0%, p = 0.7997). An analysis excluding two major studies showed an occlusion rate of 81% (48/61; 95% CI: 71%-91%), with minimal heterogeneity. The overall rate of complications stood at 14% (21/128; 95% CI: 8%-21%), with the predominant complications being thromboembolic events, in-stent stenosis, and hemorrhagic issues. Funnel plots did not indicate any signs of publication bias.Conclusion Flow diversion seems to be a promising treatment method for distal MCA aneurysms, providing high rates of complete occlusion with an acceptable profile for complications. However, the existing data remain limited and heterogeneous. Larger prospective studies with standardized reporting of outcomes are essential to determine its definitive role in this complex vascular area.Disclosures T. Patel: None.