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Objective:Complete obliteration of aneurysm while preserving the parent artery, its branches, and perforators is sometimes difficult in case of internal carotid artery(ICA) aneurysm because of its anatomic feature. To solve this problem, we report an experience of neuroendoscope in the surgery of the ICA aneurysm. Methods : Between September 2002 and May 2003, eighteen patients with 19 ICA aneurysms underwent microsurgical clipping with the help of the neuroendoscope. A rigid rod lens neuroendoscope (Karl Storz, Tuttllingen, Germany) with the diameter of 4.0mm and angles of 0 or 30 degrees was used for all patients. Results : The clips were repositioned or changed in 6 patients with detection of remnant aneurysm in neuroendoscope. Occlusion of the branch of anterior choroidal artery by clip in 2 patients was observed along the aneurysmal neck in neuroendoscope. There were no neuroendoscope-related complications. Conclusion : Neuroendoscope is a safe and useful instrument to confirm the optimal position of the clip in the microsurgery of patients with ICA aneurysm. Key words:Endoscopes;Internal carotid artery;Aneurysm;Microsurgery.