To analyze the safety and efficacy of stent-assisted coil curative embolization in acute-stage ruptured intracranial aneurysms. Methods 205 patients with acute-stage ruptured intracranial aneurysms who were treated by endovascular treatment at Department of Cerebrovascular Disease, The Second Affiliated Hospital, Kunming Medical University between January 2017 and October 2022 were included in this retrospective analysis. The clinical relevant data of all patients were collected included general conditions, surgical methods, modified Raymond-Roy occlusion classification at end of procedure and last follow-up, perioperative and follow-up complications and clinical outcome. Results 205 patients had stent-assisted coil embolization (SAC) group and 128 no-stent coiling (NSC) group. Immediate postoperative embolization rate ( Raymond grade I occlusion )was 76.6% in SAC group and 75.0% in NSC group. There was no statistically significant difference between the two groups. Clinical follow-up data were available for 188 patients, with 85 patients receiving at least once DSA follow-up. At last follow-up, grade I embolization rate was 97.4% (37/38) in SAC group and 91.5% (43/47) in NSC group , and 3 aneurysms recurrence (3/38,7.9%) in SAC group and 9 recurrence (9/47,19.0%) in NSC group, none of which were statistically significant. There was no significant difference in the SAC group in overall intraoperative complication rate (13.0%, 10/77) versus the NSC group (9.4%, 12/128).7 patients (9.1%) occurred aneurysm rebleeding in the SAC group within 1 month after surgery, which was significantly higher compared with the NSC group (1 case, 0.8%), but the overall complication rate between the SAC group(18/77,23.4%) and the NSC group (20/128,15.6%) was no statistical differences. At the follow-up end point, The total mortality rate and the good prognosis rate between the two groups were no significant difference.Conclusions SAC is safe and effective in treating intracranial ruptured aneurysms in the acute phase. The use of antiplatelet agents does not increase the incidence of intraoperative hemorrhagic events, but we should still be alert to the risk of postoperative bleeding due to antiplatelet therapy when the aneurysm was incomplete embolization.