The method of early and mid-term microsurgery for ruptured intracranial aneurysms was discussed, and the intraoperative and postoperative complications and treatment methods were discussed. All 26 patients admitted to our department between March 2004 and September 2007 were treated with microsurgery in the early and middle stages, 16 with early surgery and 10 with middle surgery. All 26 patients underwent microsurgery in the early and middle stages, 16 in the early stage and 10 in the middle stage (early stage refers to within 3 days after subarachnoid hemorrhage; middle stage refers to within 4-10 days after subarachnoid hemorrhage). The GOS score was grade I in 15 cases; grade II in 3 cases; grade III in 4 cases; and grade IV in 2 cases. Postoperatively, all patients were reexamined with cranial CT, and there were no postoperative intracranial hematomas, 10 cases with different sites of infarction, and 5 cases with preoperative CT examination showing cerebral infarction. Two cases died, one case was occipital infarction after posterior communicating artery aneurysm clamping, brain herniation occurred, and the family gave up treatment. one case was re-emitting blood 2 years after anterior communicating artery aneurysm embolization, and sudden occipital foramen hernia occurred one week after surgical clamping. The whole brain angiography was performed in 12 patients after surgery, and one patient showed that the anterior communicating artery aneurysm was completely unclamped, one case had a residual neck of the posterior communicating artery aneurysm, and one case showed that the posterior communicating artery and the anterior choroidal artery were not visualized in the angiography after postoperative clamping of the posterior communicating artery aneurysm. Early to mid-term microsurgery is an effective method for treating intracranial aneurysms. Postoperative cerebral ischemia is a serious complication of intracranial aneurysm surgery, especially for aneurysms of the posterior communicating segment of the internal carotid artery, and intraoperative protection of the anterior choroidal artery and the posterior communicating artery is very important. Further studies are needed for the surgical treatment of patients with calcification or atherosclerosis in the aneurysm-carrying artery and aneurysm body.