Objective To investigate the influencing factors for the complete recovery of neurological function in young and middle-aged patients with oculomotor nerve palsy caused by posterior communicating artery aneurysms.Methods The patients （aged 18-60 years） with oculomotor nerve palsy caused by posterior communicating artery aneurysms who were admitted to Tongji Hospital， Tongji Medical College Affiliated to Huazhong University of Science and Technology， from January 2014 to January 2020 were enrolled， and according to the recovery of oculomotor nerve palsy， they were divided into complete recovery group with 63 patients and incomplete recovery group with 26 patients. Related clinical data were compared between the two groups， and related influencing factors were analyzed.Results The logistic regression analysis showed that type of oculomotor nerve palsy （odds ratio ［OR］ = 0.144， 95% confidence interval ［CI］： 0.030-0.688， P = 0.015）， treatment modality （OR = 7.622， 95% CI： 1.823-31.870， P = 0.005）， and duration of oculomotor nerve palsy before treatment （OR = 0.848， 95% CI： 0.783-0.919， P = 0.000） were influencing factors for the the complete recovery of neurological function.Conclusions In young and middle-aged patients， the treatment modality of craniotomy and clipping has a better clinical effect than interventional embolization in helping with the complete recovery of oculomotor nerve palsy. The severity of oculomotor nerve palsy before surgery is also associated with the complete recovery of neurological function， and the duration of oculomotor nerve palsy before treatment is the best predictive factor for complete recovery.