SAH has a high mortality rate and can leave severe sequelae. Nowadays, treatment of ruptured intracranial aneurysms has made a lot of progress, especially endovascular treatment (EVT) and surgical treatment. Objectives: 1/ To describe the dinical features and imaging of SAH due to ruptured MCA aneurysms. 2/ To comment on the results of treatment of SHA due to ruptured MCA aneurysms. Subjects and Methods: prospective cross-sectional study of 54 patients who suffered from SHA due to ruptured MCA aneurysms and admitted to the Bach Mai Hospital from 1/2009 to 12/2010. Results and conclusions: There were 26 females and 28 males, the mean age was 56 years. The most common symptoms were: headache 100 percent, neck stiffness 92.5 percent, nausea and vomiting 59.3 percent, decreased consciousness 42.6 percent, 37 percent hemiparesis, 22.2 percent language disorders. Brain CT scan revealed subarachnoid hemorrhage in the sylvian fissure 31.5 percent, temporal lobe hematoma 29.6 percent, putaminnal and internal capsule hematoma 11.1 percent. Approximately 74 percent of aneurysms neck size were small and medium. The average size of aneurysms was 6.0mm, most MCA aneurysms occurred at the bifurcation 79.6 percent, right 55.6 percent, left 37 percent, both sides 7.4 percent. Treatment: surgical treatment 48.1 percent, endovascular treatment 31.5 percent, medicine treatment 13 percent, good recovery 55.6 percent, moderate sequelae 18.5 percent, severe sequelae 9.2 percent, vegetable 1.9 percent and mortality 14.8 percent. Glasgow Outcome Scale 2 of the surgical treament and endovascular treatment had no difference (p 0.05).