Background: Intracranial aneurysm is a common medical problem affecting people of both sexes. Diagnosis of intracranial aneurysm is critical and the management differs according to many factors to be either surgical clipping or endovascular coiling. Objective: To evaluate the effectiveness, advantages and risks of different modalities of treatment of different types of intracranial aneurysms. Patients and methods: The study has been conducted on patients presented with intracranial aneurysms in Al-AzharUniversity hospitals and Damanhur Medical National Institute, from July 2019 to June 2021. In this study, there were 48 patients with intracranial aneurysms either ruptured or not: 26 patients have been treated with endovascular coiling, and 22 patients had surgical clipping. All patients in the study have been subjected to complete history and clinical examination. Radiological investigations were done using either Computed Tomography (CT) of the brain, CT Angiography or digital subtracting angiography. Results: The mean admission period for endovascular coiling was 4.5 days, while for clipping was 6.27 days, and 46.2% of endovascular cases had intraoperative complications compared to 50% of clipping cases. The rates of post-operative complications were 42.3% and 45.5% for endovascular coiling and clipping respectively. Complete occlusion was achieved in 76.9% of endovascular cases, and 86.4% of clipping cases. 88.5% of endovascular cases had favorable clinical outcome compared to 90.9% of clipping cases. Conclusion: Surgical clipping has a better occlusion rate, lower rate of recurrence and re-bleeding. It has the advantage of lower direct and total cost of the intervention. Endovascular coiling has a shorter period of hospital stay and fewer symptoms during follow up period. Both techniques were similar regarding the rate of perioperative complications and clinical outcome.