Abstract: Objective To study the therapeutic effect and long-term prognosis of multiple intra-cranial aneurysms(MIA) after craniotomy. Methods Clinical data about 40 MIA patients (94 aneurysms) after craniotomy in our hospital from April 2010 to December 2012 were retrospectively analyzed. Of the 40 patients, 34 underwent primary operation and 4 underwent secondary operation. Of the 94 aneurysms, 85 were clipped, 2 were isolated, 1 was removed and 6 non-ruptured didn't undergo surgery. The success rate and mortality were assessed according to their clinical symptoms and imaging fndings. The short- and long-term outcomes of the patients were assessed following the Glasgow outcome scale (GOS). Results The effective cure rate (GOS score=4-5) was 92.25% (37/40), the ineffective cure rate (GOS score=1-3) was 7.25% (3/40), the operation-related mortality was 2.50% (1/40) for the 40 patients at discharge, and was 91.67% (33/36), 8.33% (3/36), 2.78% (1/36) for the 40 patients during the 8-40 months followup period. Conclusion Well-designed strategy is the key to surgical treatment of MIA and can result in good outcomes.