SAH from ruptured intracranial aneurysms is a serious disease with mortality of 50% to 60%, and morbidity of 20% to 30%. Patients with aneurysmal rebleed have an even poorer prognosis, with a mortality rate of 70% to 90%.[16] The primary purpose of neurosurgical treatment of ruptured aneurysms is to prevent a rebleed. The 1983 cooperative aneurysm study,[17] that analyzed 2265 patients, concluded that the rate of rebleeding was maximum (4.1%) during the first 24 hours. The cumulative rate of rebleeding was 19% during the first two weeks. In the Danish aneurysm study group report of 1987, covering 1076 patients[16] the daily rate of rebleeds during the first two weeks, calculated using a life table method, varied from 0.2% to 2.1%. The maximum rate of rebleeds was 2.1% between days 4 and 9. The cumulative rate of rebleeding was 16.8% during the first 2 weeks. A notable finding of this study was that a significantly higher rate of rebleeding was demonstrated in patients in poor clinical grades (Hunt and Hess grades III to V), compared to those in good clinical grades (Hunt and Hess grade I and II).[15] A number of studies reported in the literature have now shown that early surgery does not expose the patient to increased risk of surgical complications.[3],[4],[5],[6],[7],[8],[9] It also minimises the hazard posed by rebleeding and vasospasm. It is a common experience in almost all neurosurgical centres that even when the accepted policy is of early surgery, patients are still lost due to rebleed while waiting for angiogram or surgery. Roos et al[18] reported that, in Dutch neurosurgical centres practising early surgery, rebleeding was the cause of poor outcome in 35% of all the patients with a poor outcome. The International cooperative study[19] reported that number of patients with rebleeding increased progressively with longer intervals of planned surgery from approximately 6% for days 0 to 3 to approximately 22% for days 15 to 32. Of all the patients admitted to a neurosurgical unit within 3 days of aneurysmal SAH, 25% died. Vasospasm and rebleeding are the leading causes of death in addition to the effect of the initial haemorrhage'.[19] Most favorable outcome and lowest mortality rate is achieved in alert patients (Grades I and II) in whom surgery is performed on days 0 to 3 or after day 10 post SAH. Patients who were drowsy preoperatively (Grades III to V) have the most satisfactory results when the surgery was performed after day 10.[20] However, the advantage gained by late surgery is neutralized by an increasing incidence of rebleeding during the waiting period.