Background: Middle meningeal artery embolization (MMAE) is increasingly used to treat chronic subdural hematomas, arteriovenous fistulas and meningiomas. Less commonly, MMAE is performed for pseudoaneurysms and aneurysms. While procedural safety and efficacy in the context of the former diseases is well-documented, data for MMA aneurysm/pseudoaneurysm treatment are scarce. Methods: We conducted a systematic review using PubMed/Medline and GoogleScholar, targeting studies published in English since 1994. Original research studies and case reports involving adult patients (≥18 years) with aneurysms or pseudo-aneurysms treated with MMAE were included. Data on complications, outcomes, procedural techniques, and embolization materials were analyzed using descriptive statistics. Results: Of 1,690 identified studies, 600 underwent full-text review, and 27 studies/case reports focusing on MMAE for pseudoaneurysms and aneurysms were included in the final analysis. In most cases, the treatment was successful, with complete (pseudo-)aneurysm occlusion in all patients and symptom improvement in 24 of 28 patients (85.7%). Complications were rare, occurring in <5%, and mild, such as transient headaches (n=1) which resolved spontaneously. Conclusions: MMAE appears to be a safe and effective treatment for pseudoaneurysms and aneurysms, with minimal complications and high success rates. However, available data are scarce and from case reports only, limiting generalizability. Confirmation in larger, multi-center studies is needed.