This is a question that every patient and family faces: Is it better to have a traditional craniotomy or interventional treatment? Craniotomy to prevent rupture and bleeding of intracranial aneurysm, the aneurysm can be exposed from outside the blood vessel through craniotomy, and the neck of the aneurysm can be clamped with a special kind of clip, so that the blood flow in the cerebral vessels will not enter the aneurysm anymore and the aneurysm will not rupture; this method has a history of more than 70 years, and with the improvement of microscopic neurosurgery technology, the efficacy has also improved continuously. The advantages are that if the aneurysm is completely clamped and no residual remains, the recurrence rate is low, and it is also appropriate for patients with a large combined intracranial hematoma, which can be removed at the same time as the surgery. The disadvantage is that the cranial cavity needs to be opened, which is relatively more traumatic, and another important issue is that the procedure requires a highly experienced and skilled neurosurgeon. Another method of interventional treatment is endovascular treatment, in which a very thin tube is inserted into the aneurysm by puncturing a blood vessel at the root of the thigh and filling a spring coil into the aneurysm, which also prevents blood flow from entering the aneurysm. The advantage is that it is minimally invasive, causes little damage, and does not require an incision or opening of the cranial cavity. This approach began in the early 1990s, and the results of the international multicenter randomized controlled study (ISAT) showed that the interventional approach was superior to open cranial clamping, reducing mortality and disability in patients. The disadvantage is that it is currently more costly and has a relatively high recurrence rate. In developed Europe, most patients choose this less invasive and safer interventional treatment method. Which method to choose? For most intracranial aneurysms, both methods are available. The choice of method is based on the location of the aneurysm, the morphology of the aneurysm, the patient’s age, the patient’s general condition, the patient’s status after the onset, etc. The choice of method is also based on the experience of the physician.