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Extracranial-intracranial (EC-IC) bypass is a procedure in which a blood vessel outside the skull is connected to one inside the skull to improve cerebral blood flow. Certain aneurysms cannot be treated through standard clipping, and EC-IC bypass may be recommended in such cases. A vast body of literature exists on the use of EC-IC bypass as a treatment for cerebrovascular disorders. While beneficial to surgeons, these publications may not reach all the intended audience, which encourages the use of bibliometric analyses. Although a fraction of historically meaningful publications may not have been sufficiently valued through citation count, bibliometric analysis is the gold standard for assessing the impact of a publication. Using bibliometric analysis, we queried the Web of Science database to identify the 50 most impactful publications on EC-IC bypass based on citation count. The literature search retrieved 125 publications that met inclusion criteria, from which the top 50 most-cited ones were selected. The mean number of citations for each article was 117.06 (range 35–1437). Case reports and series constituted 15 (30%) of the top 50 publications on EC-IC bypass, followed by 8 (16%) editorials and 7 (14%) randomized controlled trials. A total of 265 authors in 10 countries contributed to the 50 manuscripts, which were published in 15 different journals. We retrieved the top 50 most-cited articles on EC-IC bypass surgery and identified the landmark publications to provide a foundational understanding of the procedure as a treatment for complex disorders. [ABSTRACT FROM AUTHOR]