Abstract: Objective To investigate the therapeutic effects of endovascular management for aSAH caused by ruptured aneurysm of poor grade(Hunt-Hess grade,4-5). Methods we retrospectively 36 patients with poor grade aneurismal SAH admitted to our hospital ,of which 28 were Hunt-Hess Grade Ⅳ and the rest grade Ⅴon admission. Early endovascular treatment was carried out in these patients ,the data of these patients including patient demographics, morphologic features of the aneurysms ,treatment results and follow-up data were collected and analyzed .Results The early interventional procedures were completed in all patients ,Angiography immediately after the treatment showed that the aneurysm of the total 32 patients were obliterated ,After a follow up period of 3- 18 months ,good prognosis was 55.5%(20/36),the poor prognosis was 13.8%(5/36),and the mortality rate was 8.39%(3/36). Conclusion Patients with poor grade aneurismal SAH should be treated aggressively; Interventional embolization by using detachable coils is a safe ,mini-invasive and effective therapy with few complications, and also can receive satisfying prognosis.