The paper presents the surgical outcomes of 300 patients with brain arterial aneurysms. A total of 43% of the patients were admitted to the unit within the first 72 hours of the onset of hemorrhage, 165 patients were operated on within the first fortnight, 135 were operated on in later periods. The aneurysms of the anterior communicating artery, internal carotid, middle cerebral artery were 42, 24, and 22%, respectively. Multiple aneurysms were 12% according to the Hunt and Hess classification, the preoperative severity of the patients was as follows: Degree I, 39 (13%), patients, Degree II, 130 (43%), Degree III, 106 (36%), Degree IV, 18 (6%), Degree V, 7 (2%). In 14% of the patients, aneurysm rupture was accompanied by the formation of intracerebral hematoma. The qualitative analysis of angiograms revealed vascular spasm in 70% of cases, the quantitative one indicated it in 80%. Aneurysm clipping was performed in 269 patients, its wrapping with a free muscle flap was done in 31 patients. Among the patients operated on, the mortality was 35% in the first fortnight of the onset of the disease and 17% during operations in later periods.