After an aneurysmal rupture, the peak period for mortality and morbidity is within the first 14 days, mainly due to rebleeding and vasospasm.[1] In the early days of aneurysm surgery, concerns about rebleeding often prompted the treating neurosurgeon to operate upon the patient as soon as possible. However, surgeons were often confronted with swollen brains making retraction and visualisation of vital structures very difficult. As a result operative mortalities were unacceptably high. In 1953, Norlen and Olivecrona[2] published a series of 100 patients with aneurysmal subrachnoid haemorrhage (SAH) who underwent delayed surgery, more than 3 weeks after the ictus. They reported a 3% mortality. This paper influenced many neurosurgeons to adopt delayed surgery for aneurysmal SAH. After the introduction of operating microscope and refinement in the techniques of neuroanaesthesia and brain protection , surgery for intracranial aneurysms became much easier and safer. In the past 15 years the results of early surgery have begun to compare[3],[4],[5],[6],[7],[8],[9] with those of delayed surgery, particularly for alert patients. Early surgery has generally been accepted as surgery within 72 hours of aneurysmal SAH in grade I and II patients. Surgery is postponed if the patients in grade I and II are admitted from days 4 to 11 post SAH.[2],[4],[5],[6],[7],[8],[9],[10] Freckmann et al,[5] argued in favour of surgery as soon as possible after admission in grade I to III. At the neurosurgical services of All India Institute of Medical Sciences (AIIMS), grade I to III patients undergo surgery soon after admission, irrespective of the time the patient presents after the ictus. Grade IV and V are taken up for immediate surgery, only if the patient has a large intracranial haematoma. However we have experienced that despite subjecting patients to early surgical intervention, irrespective of when the ictus was, patients with a potentially good prognosis are still lost due to rebleeding while awaiting an angiogram or surgery. To minimise the number of patients who rebleed after admission, the senior author (VSM) has been operating upon patients with aneurysmal SAH on an emergency basis. This paper is a retrospective analysis of the results of emergency aneurysmal surgery versus early aneurysmal surgery performed in the same department during the period January 1995 to June 1996.