In order to define the surgical result for ruptured anterior circulation aneurysms in the elderly, 59 patients(from June 1989 to May 1994) whose age was 66 years of age or older were analyzed. The factors which might influence the outcome were statistically compared between those aged 66 years or older(elderly patients group:59 patients:12.5%) and those aged 65 years or younger(younger patients group :413 patients;87.5%);the clinical grading, the location of aneurysms, the multiplicity, the presence of the angiographic vasospasm, the development of the symptomatic vasospasm, the presence of the hypertension. Fisher's grade IV(intracerebral hemorrhage or intraventricular hemorrhage), and the timing of surgery. Overall outcome between two groups was not different significantly, and many factors did not affect the outcome except the location. Surgical outcome in good grade patients(Hunt and Hess Grade I, II) was excellent regardless of age and timing of surgery. "Early surgery in the elderly?" The answer was Yes especially in good grade patients. We conclude that surgical outcome for ruptured anterior circulation aneurysms in the elderly does not seem to be directly affected by age, so elderly patients need not therefore be excluded from the benefits of surgery just because of their chronological age. It is principally the patient's condition during the acute stage that determine the surgical outcome.