Algra AM, et al. - Between January 1, 2011 and January 1, 2017, via a PubMed, Excerpta Medica Database, and Cochrane Database search for studies published that assessed current procedural clinical 30-day complications and the case-fatality rate (CFR) from endovascular treatment (EVT) and neurosurgical treatment (NST) of unruptured intracranial aneurysms and risk factors of clinical complications. Studies assessing clinical complications, CFR and risk factors, including 50 or more patients with EVT or NST for saccular intracranial aneurysms without rupture after January 1, 2000 were eligible. Female sex, diabetes, hyperlipidemia, cardiac comorbidity, wide aneurysm neck, posterior circulation aneurysm, stent-assisted coiling, and stenting were factors associated with complications from EVT. Age, female sex, coagulopathy, use of anticoagulation, smoking, hypertension, diabetes, congestive heart failure, posterior aneurysm location, and aneurysm calcification were factors associated with complications from NST. The pooled clinical complication risk was 4.96% and the CFR was 0.30% for EVT. The pooled complication risk was 8.34% and the CFR was 0.10% for NST.