Abstract： Objective To investigate the treatment strategies and clinical efficacy of interventional therapy for fetal posterior communicating artery aneurysms (PCOAA). Methods A retrospective analysis was performed of clinical data from 13 patients with fetal PCOAA treated at the Department of Interventional Radiology,Affiliated Hospital,Xuzhou Medical College between January 2009 and April 2014. All patients were treated with coil embolization of the aneurysms. DSA angiography,CT and clinical follow?up were conducted to observe the therapeutic efficacy of fetal PCOAA. Modified RANKIN Scale (mRS) scores at hospital discharge were used to evaluate the prognosis of patients. Results Of these patients,two were treated with balloon?assisted,five with stent?assisted and six with direct coil embolization of aneurysms. The coil embolization of aneurysm was complete in 10 patients and partial in 3. In 5 patients,the embolization was performed at the proximal part of posterior communicating artery. The posterior communicating artery retained patency after treatment. In one patient who experienced rupture of aneurysm during the procedure, the hemostasis was achieved by packing and the CT scan immediately after operation showed minimal subarachnoid hemorrhage. One patient required cerebrospinal fluid shunt for postoperative hydrocephalus. At discharge,there were 11 cases with mRS score grade 0,1 with grade 1,and 1 with grade 6. The during the follow?up of 6 to 24 months (mean 12 ± 3 months),there was no recurrence of bleeding in the patients. Conclusion For fetal PCOAA,different treatment strategies based on the extent of PCOAA can achieve favorable clinical outcomes,although the long?term effects require further observation.