Management of intracranial aneurysms remains controversial. For unruptured aneurysms, many factors should be taken into account before deciding the type of treatment and whether to treat or not. Ruptured aneurysms on the other hand are almost always treated. Still, the question remains what are the indicators that one must rely on to decide what treatment suits the patient best. We present a review on the management of intracranial aneurysm while focusing on endovascular aspects.