Subfalcial herniation secondary to a unilateral supratentorial space occupying lesion is frequently seen on the brain CT scan, however, the development of distal anterior cerebral artery infarction following compression of the terminal branches of the pericallosal artery against the falx during the period of subfalcial herniation is uncommon. For the last three years, we have experienced three cases of distal anterior cerebral artery infarction caused by subfalcial herniation of the brain CT scan. All patitnts had acute subdural hematomas resulting in subfalcial herniation on the first CT scan and subsequently developed focal infaretions in the ipsilateral paracentral lobule. The patients did not improve clinically and died several days after operation. The development of such infarction may reflect severe cerebral injury and portend a poor clilnical outcome.