Anterior communicating artery aneurysm is the most common type of intracranial aneurysm. Once ruptured, the symptoms are often severe and the prognosis is adverse. In recent years, with the development of imaging 3D reconstruction technology and the rise of computational fluid dynamics, related morphological features and abnormal hemodynamic changes during the initiation, development and rupture of anterior communicating artery aneurysms have been gradually revealed. Studies have shown that the characteristics of the largest diameter, aspect ratio, and size ratio of anterior communicating artery aneurysms can help predict the risk of rupture, dysplasia of the A1 segment on one side of the anterior cerebral artery, and the angle between the A1 and A2 segments of the anterior cerebral artery and anterior communicating artery aneurysm. Hemodynamic changes play an important role in the formation and rupture of aneurysms. This article reviews the relationship between the morphological characteristics of anterior communicating artery aneurysms and abnormal hemodynamic changes, and discusses the internal mechanism of the interaction between them, so as to provide evidence and new ideas for the early prevention and treatment of anterior communicating artery aneurysms.