Objective To investigate the efficacy and safety of stent-assisted coil curative embolization in the treatment of acutely ruptured intracranial aneurysms.Methods A retrospective analysis was performed for 205 patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms who received endovascular treatment in Department of Cerebrovascular Diseases， The Second Affiliated Hospital of Kunming Medical University， from January 2017 to October 2022. Related clinical data were collected， including general status， surgical methods， embolization rate immediately after surgery and at last follow-up based on the Raymond classification， and complications during the perioperative period and follow-up， and the modified Rankin Scale was used to evaluate clinical prognosis.Results Among the 205 patients， 77 were enrolled in the stent-assisted coiling （SAC） group and 128 were enrolled in the non-stent coiling （NSC） group. There was no significant difference in the rate of Raymond grade I embolization immediately after surgery between the SAC group and the NSC group （76.6% vs 75.0%， P>0.05）. Clinical follow-up was performed for 188 patients， with 85 patients receiving at least one session of DSA follow-up. There were no significant differences between the SAC group and the NSC group in the rate of grade I embolization at last follow-up ［97.4% （37/38） vs 91.5% （43/47）， P>0.05］ and recurrence rate ［7.9% （3/38） vs 19.1% （9/47）， P>0.05］. There was no significant difference in the incidence rate of intraoperative complications between the SAC group and the NSC group ［13.0% （10/77） vs 9.4% （12/128）， P>0.05］. Within 1 month after surgery， 7 patients （9.1%） in the SAC group and 1 patient （0.8%） in the NSC group experienced rebleeding of aneurysms， and there was no significant difference in the incidence rate of complications between the SAC group and the NSC group ［23.4% （18/77） vs 15.6% （20/128）， P>0.05］. At the end of follow-up， there were no significant differences between the two groups in overall mortality rate and good prognosis rate （P>0.05）.Conclusions SAC is safe and effective in the treatment of acutely ruptured intracranial aneurysms. The use of stents does not increase the risk of ischemic events， and the use of antiplatelet agents does not increase the incidence rate of intraoperative hemorrhagic events， but we should be alert to the risk of postoperative bleeding due to antiplatelet therapy in case of incomplete embolization of the aneurysm. Further studies are needed to clarify whether SAC can reduce the recurrence rate of aneurysms.