Objective To compare the effecacy of microsurgical clipping versus endovascular coiling in patients with aneurysmal subarachnoid hemorrhage in the first affiliated hospital of Chongqing medical university.Methods To follow-up the patients with subarachnoid hemorrhage(SAH) caused by ruptured intracranial aneurysm in our department from January 2008 to December 2009, 109 cases were achieved information. 79 cases (69 (87.3%)with Hunt-HessⅠ-Ⅱ, 10(12.7%) with Hunt-Hess Ⅲ-Ⅴ)were assigned to clip, 30 cases (26 (86.7%)with Hunt-HessⅠ-Ⅱ, 4 (13.3%)with Hunt-Hess Ⅲ-Ⅴ)were assigned to coil. when the discharge, in the surgical group, the number with good outcome was 69 (69 with Hunt-HessⅠ-Ⅱ), 6 (10 with Hunt-Hess Ⅲ-Ⅴ), 1 case died, the average hospital stay was (22.7±3.2) days. In the endovascular treatment group, the number with good outcome was 26 (26 with Hunt-HessⅠ-Ⅱ), 2 (4 with Hunt-Hess Ⅲ-Ⅴ), 1 case died, the average hospital stay was(13.4±3.4)days.Results After 3 months to 2 years' follow-up, in the surgical group, 76 cases (96.2%)with good outcome, 3 cases (3.8%)with bad outcome, 2 cases (2.5%)died, 1 case (3.4%)paralyzed. In the endovascular treatment group, 28 cases(93.3%) with good outcome, 2 cases (6.7%)with bad outcome, 1 case (3.4%)died, 1 case (3.4%)paralyzed. Imaging information, 63 cases (79.7%)of 79 cases were achieved follow-up in the surgical groups, 59 cases(93.7%) were complete occlusion. 21 cases(70%) of 30 cases were achieved follow-up in the endovascular treatment group, 19 cases(90.5%) were complete occlusion. It did not differ significantly.(P=0.625).Conclusions The short-term clinical results and the outcome of follow-up between the surgical and endovascular treatment groups, do not differ significantly. The complete clipping rate in the surgical group is higher than that the in the endovascular treatment group. The average hospital stay in the endovascular treatment group is shorter than that in the surgical group.