Cerebral aneurysms are aneurysmal protrusions of the arterial wall due to limited abnormal dilatation of the lumen of the intracerebral arteries, which are common clinical vascular diseases and the most common cause of spontaneous subarachnoid hemorrhage. The key to the treatment of intracranial aneurysms is etiologic treatment, i.e., surgical or endovascular embolization of intracranial aneurysms, which must address the root cause of the disease, followed by symptomatic treatment of subarachnoid hemorrhage and its complications. The treatment of aneurysms depends on the patient’s physical condition, the size of the aneurysm and its anatomical location, the surgeon’s surgical management ability, and the level of equipment in the operating room. For most ruptured aneurysms, the best treatment is surgical clamping of the aneurysm neck or endovascular embolization of the aneurysm lumen to exclude it from circulation without occluding the normal vessels, thus preventing rebleeding and enlargement of the aneurysm. The symptomatic treatment can be summarized as “three reductions (blood pressure, cranial pressure, and temperature), two resistances (anti-cerebral vasospasm and anti-infection), and one drainage (drainage from the cerebral pool or ventricular area or lumbar pool). Intracranial aneurysm surgery can be divided into early surgery and late surgery according to the time of surgery, and craniotomy is feasible for patients without obvious contraindications to surgery. The treatment of subarachnoid hemorrhage mainly includes general treatment, medication, prevention and treatment of cerebral vasospasm and management of hydrocephalus after subarachnoid hemorrhage. With the continuous development of interventional and microsurgical techniques and the further understanding of cerebral vasospasm and its prevention and treatment, a consensus has been formed in recent years to advocate early treatment of ruptured aneurysms.