Objective To investigate the influencing factors for neurological complications in elderly patients with ruptured intracranial aneurysms (RIAs) treated with interventional therapy. Methods A retrospective analysis was performed on 350 elderly patients with RIAs who underwent endovascular embolization in our hospital from June 2012 to October 2018, using their clinical data from outpatient and inpatient medical records. A multivariate logistic regression model was established to analyze the factors influencing the occurrence of neurological complications related to endovascular embolization. Results Of the 350 patients, 36 patients (10.26%) developed neurological complications, including 8 patients with intraoperative aneurysm rupture and hemorrhage, 9 with postoperative aneurysm rupture and hemorrhage, 5 with new subdural hemorrhage or cerebral hemorrhage, and 14 with thromboembolism. Univariate analysis showed that hypertension (χ²=8.750), Hunt-Hess grade (χ²=18.314), aneurysm diameter (Z=-8.357), and wide-necked aneurysm (χ²=10.368) were influencing factors for the neurological complications (P<0.05). Logistic regression analysis further confirmed that hypertension (OR=3.503), Hunt-Hess grade (OR=3.290), aneurysm diameter (OR=3.571), and wide-necked aneurysm (OR=2.191) were the independent factors (P<0.05). Conclusions Hypertension, Hunt-Hess grade, aneurysm diameter, and wide-necked aneurysm are independent factors for neurological complications related to endovascular embolization in elderly patients with RIAs.