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Objective To explore the optimal moment of surgical management for the anterior circulation aneurysms, and to summarize the experience of microsurgical treatment for the anterior circulation aneurysms. Methods The clinical data of 210 patients with anterior circulation aneurysms were retrospectively analyzed. In 183 patients with subarachnoid hemorrhage, there were 82 cases of grade Ⅰ -Ⅱ, 77 cases of grade Ⅲ, 21 cases of grade Ⅳ, 3 cases of grade Ⅴ according to Hunt⁃Hess grade. Results 199 patients underwent aneurysm clipping and 11 patients were underwent aneurysm wrapping. According to Glasgow Outcome Scale (GOS) classification criteria for the prognosis, 97 cases (46.19% ) cured, 80 cases (38.09%) had slight disability, 24 cases (11.43%) showed severe disability, and 9 cases (4.29%) died. Conclusion In the microsurgery for anterior circulation aneurysms, the patients should be early operated according to the individual clinical signs. The judgment and skills in surgery for the subtypes of anterior circulation aneurysms are the key points to cure intracranial aneurysms successfully. DOI：10.3969/j.issn.1672⁃6731.2012.01.012