In this episode, we delve into the natural course and long-term outcomes of giant cerebral arteriovenous malformations (AVMs) exceeding 6 cm. Based on a national multicenter propensity score-matched cohort study, published in the European Journal of Neurology in 2026, this full-text review examines a significant patient population to understand the clinical trajectory of these complex lesions. The research highlights key findings regarding event rates and prognosis, offering crucial insights for clinicians managing patients with giant AVMs. Understanding these outcomes can inform treatment decisions and patient counseling. This information is for educational purposes and does not constitute medical advice. The content reflects the findings of the original study and is not a substitute for professional medical expertise.