Abstract Cerebral aneurysms are pathological dilation of blood vessels. Although the exact pathogenesis of these lesions is unknown, it is believed that chronic stress and inflammation have key roles in the development of aneurysms. The risk of rupture of a cerebral aneurysm ranges between 1% and 3% per year. Despite the low annual risk of rupture, aneurysmal subarachnoid hemorrhage can be a devastating complication. Patients who meet the treatment criteria should have their aneurysm evaluated by a neurovascular team. The ideal treatment of cerebral aneurysms remains controversial, and both microsurgical clipping and endovascular embolization are the widely used treatment options. The microsurgical management of cerebral aneurysms and endovascular embolization is discussed separately. Relative to endovascular treatment, microsurgical treatment of aneurysms is a more invasive and also a more durable treatment option.