It is known that the profile of aneursyms in the paediatric age group demonstrates a different biology and epidemiology than those in the adult population in terms of size, sex, location, multiplicity and complications such as vasospasm and rebleeding. As a consequence of their different behaviour, timing of surgery does not appear to be such a critical issue in their management decision. Surgical clipping is still the treatment of choice, however, with our growing experience of endovascular techniques, these might prove to be a suitable alternative in the future. We report the results of our surgical series of 17 paediatric and adolescent patients harbouring 18 arterial intracranial aneurysms (age range 7-18 years). Systemic diseases traditionally known to be associated with this entity were excluded. In order to assess endovascular techniques as a potential treatment alternative for this group of patients, we reviewed the current literature, dealing with Guglielmi detachable coil (GDC) embolization of arterial cerebral aneurysms in this age group. No current series deals purely with paediatric aneurysms; we have reviewed paediatric cases reported as part of large adult series. Copyright 1999 Harcourt Publishers Ltd.