Objective To investigate the clinical application of lamina terminalis fenestration (LTF) in patients with subarachnoid hemorrhage from anterior communicating artery (ACoA) aneurysm.Methods A retrospective analysis was performed for the clinical data of 51 patients with subarachnoid hemorrhage from ACoA aneurysm who were hospitalized in our hospital from July 2014 to July 2016, and according to whether LTF was performed during surgery, these patients were divided into LTF group and non-LTF group. The two groups were compared in terms of length of hospital stay, Glasgow Outcome Scale (GOS) score, and chronic hydrocephalus.Results There was a significant difference in the incidence rate of hydrocephalus between the LTF group and the non-LTF group (8.3% vs 33.3%, P<0.05). The LTF group had a significantly shorter length of hospital stay than the non-LTF group (13.83±1.24 d vs 15.39±1.90 d, P<0.05). There was also a significant difference in the GOS score between the LTF group and the non-LTF group (4.08±0.83 vs 3.30±0.82, P<0.05).Conclusions In patients with subarachnoid hemorrhage from ACoA aneurysm, LTF can shorten the length of hospital stay, reduce the incidence rate of chronic hydrocephalus, and improve their prognosis.