Subarachnoid haemorrhage due to rupture of cerebral aneurysms is a multisystem disease. Treatment of the condition in the past has relied on craniotomy and clipping of the aneurysm to prevent a recurrent haemorrhage. There is now emerging evidence to suggest that endovascular treatment of cerebral aneurysms may reduce the morbidity associated with open surgery. The anaesthetic management of interventional neuroradiology also creates new challenges due to the novel approach to treatment. Anaesthetists need to be familiar with this procedure and the management of potential complications. This review provides an overview such considerations.