Posterior inferior cerebellar artery (PICA) aneurysm is one of the causes of subarachnoid hemorrhage and posterior circulatory ischemia, which is difficult to treat and has a poor prognosis due to its complex anatomy. Depending on the location and nature of the aneurysm, the treatment options available vary. Based on the review of literature, this paper reviews the latest treatment progress of PICA aneurysms.