Intracranial aneurysm is one of the most important diseases within the scope of neurosurgical field. These aneurysms cause serious morbidity and mortality when they bleed. Intracranial aneurysm can be recognized in the asymptomatic period, with the use of new technologies in neuroradiology. Thus, the natural progress of unruptured aneurysm and comparison of alternative treatment options have come on the agenda. This article reviews the natural progress of intracranial aneurysms detected before bleeding, and alternative treatment options.