Abstract：Objective To analyze the effects of endovascular interventional therapy and micro-neurosurgical surgery in the treatment of intracranial aneurysm. Methods A total of 88 patients with intracranial aneurysms treated in our hospital were divided into the microsurgery group and the intervention group, with 44 patients in each group. The clinical efficacy, surgery-related indicators, incidence of complications, and recurrence rates of the two groups were compared. Results The clinical efficacy and recurrence rate of the microsurgery group were both superior to those of the intervention group, with statistically significant differences between the groups (χ2＝4.141, 3.880, both P＜0.05); the surgery-related indicators and incidence of complications in the intervention group were superior to those in the microsurgery group, with statistically significant differences between the groups (t＝27.842, 13.538, 10.213, 10.983, χ2＝5.091, all P＜0.05). Conclusion Both endovascular interventional therapy and micro-neurosurgical surgery have good efficacy in the treatment of intracranial aneurysms, but each has its advantages and disadvantages. A more suitable treatment plan should be chosen based on the actual condition of the patient.