Abstract： Objective To explore the safety and efficiency of lateral supraorbital (LSO) approach for the ruptured anterior circulation aneurysm.Methods The clinical data of 23 patients with grade Ⅰ-Ⅲ ruptured anterior circulation aneurysm via LSO at the Second Hospital of Shandong University from February 2016 to December 2016 were retrospectively analyzed.The clinical data included their clinical manifestations,radiological finding,microsurgical techniques and follow-up results.Results All patients were diagnosed as anterior circulation aneurysm by preoperative CT angiography (CTA) or Digital Subtraction Angiography (DSA).They all accepted aneurysm clipping via LSO.The operations carried out smoothly,with no operation related complications.They were followed up for 2 to 12 months,and the Glasgow outcome scales (GOS) were 5 in 18 patients (78.3%),4 in 2 patients (8.7%),3 in 2 patients (8.7%),and 1 in 1 patient (4.3%).Conclusion LSO could provide adequate exposure for the anterior circulation aneurysm,so the clipping could be carried out safely and effectively.LSO is a simple and minimally invasive surgical approach,and when it is used by the skilled master of pterion approach,its advantage could be fully played.