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Cerebral AVMs are still a matter of significant debate among neurological specialists. The role of intervention, medical therapy and observation is still being elucidated. Available management strategies seem to overlap, and establishing clear guidelines for individualized treatment plans depending on the available resources and expertise may contribute to management. The purpose of this report is to provide an update and recommendations from the endovascular standpoint regarding tools and techniques that we believe are key to improved outcomes. To this end, we review our cases, the current literature, and provide three illustrative cases. Improved understanding of the natural history of these complex lesions will help understand the effect that our interventions have upon them. In addition, careful evaluation of the characteristics and specific AVM risk factors, specifically pertaining to endovascular therapy, will be beneficial in establishing its role in any particular case.