During the period January 1995 to June 1996, out of a total of 153 patients admitted, under the neurosurgical services of AIIMS, with a clinical diagnosis of SAH, 127 patients had angiographically confirmed aneurysms. In 23 patients no angiogram was performed because of poor clinical status (Hunt and Hess Grade IV-19, and Grade V-4). The angiogram was withheld in 19 out of these 23 patients, who were admitted in grade IV, because they further deteriorated to grade V after admission. In 3 patients (all Grade III) an angiogram was planned for the next working day, but it could not be performed as they rebled and deteriorated to grade V while waiting for an angiogram. Hundred and nine patients underwent surgical treatment of the aneurysm, 10 patients underwent endovascular therapy of the aneurysm and one patient refused any form of therapy. Amongst these 109 patients, a giant basilar top aneurysm was found to be unclippable at surgery in one patient, and in a second patient a giant carotico-ophthalmic giant aneurysm had to be trap ligated. Successful clipping of the aneurysm was carried out in the remaining 107 patients. Seven patients suffered a fresh rebleed and died while waiting for elective surgery (grade II-I and grade III-6). Grade V patients were not taken up for angiograghy. Some selected grade IV patients were taken up for angiography, followed by surgery, if the treating surgeon felt that the patient was clinically improving.