Objective To compare the efficacy of composite surgery and embolization in the treatment of ruptured intracranial aneurysm (RICA)-induced subarachnoid hemorrhage (SAH).Methods A retrospective and descriptive analysis was conducted in patients with RICA-induced SAH (13 cases undergoing composite surgery[CS group] and 16 cases undergoing embolization[E group]) treated in Kaifeng Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Henan University from January 2016 to December 2018.Results Postoperative complications that occurred in the E group but not in the CS group were hydrocephalus (2 cases), cerebral infarction (1 case), cerebral vasospasm (1 case), and fungal infection-induced diarrhea (1 case). Postoperative complications that occurred in the CS group but not in the E group were intracranial infection (2 cases) and urinary tract infection (1 case). Postoperative complications that occurred in both groups were pulmonary infection (1 case for each group) and deep vein thrombosis of the lower extremities (1 case for each group). There were no perioperative deaths in either group. There were significant differences in the incidence of complications between the two groups (P<0.05). At the time of discharge, there were 4 and 8 cases of dysfunction in the CS group and the E group, respectively. There were significant differences in the Glasgow Outcome Scale on discharge and at follow-up between the two groups (P<0.05). Recurrent hemorrhage caused by ruptured aneurysms within 1 year occurred in the E group (1 case) but not in the CS group, yielding a significant difference between the two groups (P<0.05).Conclusions Composite surgery has some advantages in the treatment of RICA-induced SAH.