Abstract： Objective To evaluate the clinical effect of early microsurgery for ruptured cerebral anterior circulating aneurysm. Methods Diagnosis and treatnent processes of 51 patients were retrospectively analyzed: these patients were presented with anterior circulating aneurysm induced acute spontaneous subarachnoid hemorrhage and they underwent early (within 3 d) microsurgical clipping in our hospital between January 2007 and June 2009. Glasgow outcome scale (GOS) was conducted to evaluate the outcomes. Results Of the 51 patients with anterior circulating aneurysm, 47 intracranial aneurysm lesions were clipped successfully, and 4 were wrapped. Good outcome was achieved in 39 patients, mild disability (being able to look after themselves in daily life) in 4, and severe disability in 3;persistent vegetative state appeared in 3 and 3 died after the surgery. Conclusion Early microsurgery for ruptured cerebral anterior circulating aneurysm is considered as the feasible opinion, by decreasing the recurrence of hemorrhage, disabled rate and mortality.