【Abstract】 Objective To explore the effects of microsurgical clipping of aneurysm neck and endovascular embolization on delayed cerebral ischemia (DCI). Methods The clinical data of 108 patients with aneurysmal subarachnoid hemorrhage (ASAH) admitted from January 2015 to January 2017 were analyzed, retrospectively. The patients were divided into intervention group (n=52) and clipping group (n=56) according to the surgical methods. Intervention group was given endovascular embolization, and clipping group was treated with microsurgical clipping of aneurysm neck. The DCI incidence rate at 1w and 2w after operation was compared, and the levels of immune function［immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA)］and serum inflammatory factors［tumor necrosis factorα(TNFα), highsensitivity C reactive protein (hsCRP), interleukin6 (IL-6)］were recorded in the two groups before operation and at 3d after operation, and the incidence rate of complications was recorded in the two groups, and the prognosis［modified Rankin scale (mRS)］was evaluated at 6 months of followup. Results The DCI incidence rate at 1w and 2w after operation and the average mRS score at 6 months of followup in intervention group were lower than those in clipping group (P＜0.05). At 3d after operation, the levels of IgG, IgM and IgA in the two groups were lower than those before operation (P＜0.05), and the decrease in intervention group was smaller than that in clipping group (P＜0.05). At 3d after operation, the levels of TNFα, hsCRP and IL6 in the two groups were higher than those before operation (P＜0.05), and the increase in intervention group was smaller than that in clipping group (P＜0.05). There was no significant difference in the incidence rate of complications between the two groups (P＞0.05). Conclusion Endovascular embolization has lower risk of postoperative DCI than microsurgical clipping of aneurysm neck, and the former one is beneficial to improve the postoperative immune function, serum inflammatory factors and prognosis in ASAH patients.