Objective To investigate the methods of endovascular treatment for vertebral artery dissecting aneurysms (VADAs).Methods The clinical data of 41 patients with VADAs treated by our operation group from January 2006 to May 2014 were analyzed retrospectively. Of the 41 patients, 35 underwent three different endovascular treatments, and the other 6 were followed up for observation.Results The 41 patients were followed up from 3-18 months. Among them, 1 patient treated by stent-assisted coil trapping had a relapse, and 2 untreated patients suffered from enlarged aneurysms.Conclusions The data of the treatment group and the observation group were statistically analyzed (P <0.01). Endovascular treatment of VADAs is safe and reliable. Different endovascular treatments can be chosen according to the appearance of the aneurysm, the relationship with the posterior inferior cerebellar artery, the development of the contralateral vertebral artery and so on.