Subarachnoid hemorrhage is a common neurosurgical condition, mostly caused by sudden rupture of an aneurysm. Literature reports that once the aneurysm ruptures, about 1/3 of the patients will die pre-hospital, about 1/3 will die in-hospital, and the remaining about 1/3 can survive after active treatment, but about 1/3 of these cases will be left with different degrees of neurological deficits. How to improve the cure rate and reduce the mortality and disability rate is a serious challenge for neurosurgeons today. What should we do when an aneurysm ruptures and bleeds? Prevention of re-bleeding: After an aneurysm has ruptured, about one-third of the cases may survive and end up in the hospital, but these patients are always at risk of a fatal re-bleeding. Therefore, until surgery is performed, patients should be put on absolute bed rest, avoid agitation and lifting, and keep their bowels free to minimize the risk of rebleeding due to fluctuations in brain pressure. Determining the cause of bleeding: To determine the size, shape, and extent of the bleeding aneurysm, special tests are needed. At present, there are mainly three kinds of special examinations for aneurysms: ① digital subtraction angiography (DSA) ② spiral CT angiography (CTA) ③ magnetic resonance angiography (MRA) Selection of surgical plan: At present, there are two kinds of surgical methods for treating aneurysms: ① cranial clamping, which is to saw open the patient’s skull, then dissect the patient along the natural gap of the brain tissue under the microscope, and pull open the brain tissue to expose the aneurysm and clamp it shut. Clamping off the aneurysm. Interventional embolization is performed by puncturing the femoral artery on one side and inserting a guide tube with an internal diameter of 2 mm into the carotid or vertebral artery via the aorta under x-ray television monitoring. A very soft microcatheter with an inner diameter of 1 mm or thinner is then selectively fed through the catheter into the aneurysm, through which removable spring coils are filled into the aneurysm one by one to occlude the aneurysm, thus achieving the same effect as craniotomy closure. Both methods have their own advantages. Interventional therapy is favored because of its light damage, low pain and quick recovery. Selection of treatment timing: Considering the factor of aneurysm re-rupture, the operation should be arranged as early as possible, but the pathological changes of brain tissues suffered from damage after hemorrhage will increase the difficulty of the operation and the risk of the operation. Some observational studies abroad have found that early surgery results in a lower rate of residual mortality due to rebleeding than postponed surgery, but the rate of residual mortality due to cerebral vasospasm is higher in early surgery than postponed surgery. Early surgery may allow patients who would have died from rebleeding to survive, but then die from vasospasm after surgery. In recent years, many scholars advocate early surgery for patients with Hunt’s classification of 0 to 2, while patients with classification of 2, CT showing more bleeding and patients with classification of 3 or more should postpone surgery for 10-15 days until the classification drops and the condition stabilizes, although during this period, according to the doctor’s requirements to do absolutely bedridden, avoiding agitation and moving, stabilizing blood pressure, and keeping the urine and feces unobstructed, which can reduce the risk of re-rupture of the aneurysm, but the consequences of re-rupture of the aneurysm will be more serious than those of the aneurysm. However, once the aneurysm ruptures again, the consequences will be serious. the condition of grade 4~5 patients often deteriorates rapidly to a state of frequent death, and there are occasional cases of successful surgical treatment. Therefore, we should take the initiative to cooperate with doctors to choose the best treatment plan when patients are admitted to the hospital.