【Abstract】 Objective To evaluate the therapeutic effects of interventional and microsurgical treatment of acute hydrocephalus after rupture of anterior circulation aneurysm.Methods 89 patients of acute hydrocephalus after rupture of anterior circulation aneurysm were retrospectively analyzed. The patients were divided into interventional group (38 cases) and microsurgical group (58 cases). The interventional group received intervention of aneurysms and the drainage of cerebrospinal fluid. The microsurgical group received the clipping of aneurysms and the drainage of cerebrospinal fluid. The preoperative and postoperative clinical characters of the two groups were analyzed and compared. Results The preoperative clinical characters of the two groups had no significant differences(P>005). After operation, the interventional group had more intracranial hemorrhages, higher residual or recurrent rates of aneurysm, less pulmonary infection，and more chronic hydrocephalus than that of microsurgical group（P<005). The mortality and GOS of 6 months after operation between the two groups were not significantly different（P>005).Conclusion Intervention and mirosurgery are both facultative therapeutic methods for acute hydrocephalus after rupture of anterior circulation aneurysm. They have advantages and defects. The reasonable therapeutic method according clinical characters of patients can improve the therapy of acute hydrocephalus after rupture of anterior circulation aneurysm.