Objective: The most effective treatment of ruptured intracranial aneurysms is controversial in recent years. The purpose of this study is to compare the outcome of patients with acutely ruptured cerebral aneurysms treated by surgical clipping or endovascular coiling. Methods: A randomized controlled trial included 65 patients with ruptured intracranial aneurysms who undenAfent surgical clipping (35 patients) or endovascular coiling (30 patients) from 09/2016 to 06/2017 at Bach Mai Hospital. Patients in the study were examined on admission and followed during the hospitalization. Modifield Rankin Scale (mRS) was used to evaluate patients at discharge and 3 months later (by phone call). Results: At the hospital discharge, a good outcome (mRS: 0-2) was observed in 71.4% of the patients undergone surgical clipping and in 76.7% of the patients to endovascular coiling (p = 0,117). After 3 months, this rate was 80% and 83.3% (p=0,819), respectively. The percentage of well recovered patients with posterior circulation aneurysms in the surgical and endovascular group was respectively 0% and 16% (p=0,028). There was no statistically significant difference of variables between two groups: anthropometric characteristics, Hunt-Hess scale, Fisher scale, aneurysms size and outcome. Conclusions: There was no proven difference in clinical outcome between two procedures as the evidence was based on a small number of patients. The article recommend further intervention studies with large sample sizes for a better evaluation of two modalities.So sánh kết quả điều trị vỡ phình động mạch não bằng phương pháp phẫu thuật và can thiệp nội mạch trên 65 bệnh nhân. Kết quả cho thấy độ hồi phục lâm sàng của 2 nhóm phẫu thuật và can thiệp mạch là như nhau. Tỷ lệ phục hồi tốt ở nhóm bệnh nhân có phình động mạch thuộc hệ tuần hoàn sau của nhóm phẫu thuật và can thiệp mạch là 0% và 16%.