For many patients with cerebral aneurysms, endovascular therapy offers an acceptable alternative to aneurysm surgery. These neurointerventional methods are broadly classified as deconstructive or reconstructive procedures, depending on whether the parent vessel is preserved in treating the aneurysm. Results to date suggest that appropriately selected patients may be treated successfully with low technical morbidity and mortality. Whereas certain shortcomings are evident, developing technology has expanded the spectrum of aneurysms amenable to endovascular treatment and improved the effectiveness of such management.