Objective: To explore the clinical efficacy of ventricular catheterization drainage combined with urokinase lavage after interventional treatment for higher-grade cerebral aneurysmal subarachnoid hemorrhage. Method: A total of 65 patients diagnosed with ruptured intracranial aneurysms and undergoing interventional embolization were prospectively enrolled from the First Department of Neurosurgery at Hanzhong Central Hospital between January 2020 and March 2025. Participants were randomly assigned to either the simple ventricular catheterization drainage group (n=31) or the ventricular catheterization drainage combined with urokinase lavage group (n=34). Baseline characteristics, incidence of complications, and prognostic outcomes were analyzed and compared between the two groups. Result: No statistically significant differences were observed in baseline data between the two groups (P>0.05). However, three days post-surgery, the subarachnoid hemorrhage clearance rate was significantly higher in the urokinase lavage group compared to the control group (72.6% vs. 51.2%, P<0.001). Additionally, the urokinase group exhibited a lower incidence of delayed cerebral ischemia (8.82% vs. 32.26%, P=0.018), hydrocephalus (8.82% vs. 32.26%, P=0.018), and Secondary epilepsy (8.82% vs. 29.03%, P=0.036). No significant difference was found in the rate of intracranial infection between the two groups (11.76% vs. 9.68%, P=1.000). Patients in the urokinase group also demonstrated higher GCS scores at discharge (14 vs. 12, P<0.001), shorter hospital stays (13 days vs. 18 days, P<0.001), and improved neurological outcomes as indicated