BACKGROUND: There are 2 main treatments for unruptured paraclinoid aneurysms: endovascular procedures and surgical clipping. Recent advancements such as intraoperative indocyanine green video angiography (ICG-VA) are improving the safety of clipping procedure in the surgical center without intraoperative imaging. This study is a single-center experience in Vietnam to evaluate the preliminary result of a surgical series in paraclinoid aneurysms with ICG-VA. METHODS: We performed a retrospective study of 53 unruptured paraclinoid aneurysms who underwent clipping surgery from 2019 to 2023 at the University Medical Center, Ho Chi Minh City. RESULTS: All patients achieved good functional outcomes at 3 months follow-up with no mortality, and 60% of visual symptoms improved postoperatively. There were no statistically significant differences in neurological complications and radiological results between groups A (no ICG-VA) and B (using ICG-VA). Statistically significant differences were only observed in the rate of ischemia detected on computed tomography scan (P = 0.031). The rate of incompleted clipping was 18.9%, with the only significant factor for incompleted clipping being a larger maximal diameter (P = 0.044). CONCLUSIONS: Surgical clipping of unruptured paraclinoid aneurysms is a safe and feasible treatment, and good neurological outcomes can be achieved. Applying ICG-VA has provided intraoperative real-time visualization and the potential to decrease complications. The incomplete clipping rate of aneurysms in this position is still a challenge to overcome and several factors can predict this important issue.