[Objective] Explore the diagnosis of intracranial aneurysms, microsurgical operation for treatment of intracranial aneurysm.[Methods] The clinical data of 31 cases of intracranial aneurysms from July 2008 to July 2009 was analyzed retrospectively the patients were confirmed by receiving the computed tomography angiography (CTA) the transpterional approach was introduced in the craniotomy to protect the temporalis.[Results] the coincidence rate of CTA and intraoperative diagnosis for aneurysms were 100 present.Prognosis: the 13 cases recovered with normal life and work 8 cases recovered with mild nervous system symptoms 6 cases recovered with Moderate nervous system symptoms 2 cases recovered with serious neurological symptoms, 2 case died.[Conclusion] CTA technique in the diagnosis of intracranial aneurysm is accurate, reliable, and have great application value;The improved pterional approach in the treatment of anterior circulation intracranial aneurysms, the operative field can be well revealed;the skilled application of microsurgical technique, is the key to successful operation.