Previous reports of outcome after endovascular treatment of posterior cerebral artery (PCA) aneurysms have been limited. This study aimed to describe the clinical outcome and angiographic results obtained in the endovascular therapy of PCA aneurysm over a six year period. Endovascular treatment strategies were determined. A retrospective analysis was performed on 18 patients with PCA aneurysms evaluated at Beijing Tiantan Hospital between December 2000 and December 2006. Nine patients presented with subarachnoid hemorrhage (SAH): one of these patients had additional seizure and hemiparesis, one had additional memory loss and oculomotor palsy and one had additional vitreous hemorrhage. One patient had an intracerebral hematoma causing hemipalsy. Nine patients demonstrated unruptured PCA aneurysms. Ten aneurysms were = or >15 mm and the other eight were <15 mm. Ten aneurysms were saccular, four were fusiform and four were giant serpentine. Eighteen aneurysms were successfully treated with one patient deceased and one with a permanent deficit, 11 with selective occlusion of the aneurysm with platinum coils, one with NBCA and five with simultaneous occlusion of the aneurysm and parent PCA with detachable coils. One patient underwent complete spontaneous thrombosis after angiography. One patient had recanalization one year after coiling and one patient (patient 13) had persistent homonymous hemianopsia and mild hemipalsy. Five patients had parent vessels were occluded with intact visual field. Clinical presentation of PCA aneurysms varied with SAH, oculomotor palsy, heminumbness, hemiparalysis, memory loss, seizure or a combination. Various aneurysms of the posterior cerebral artery can be managed effectively with endovascular treatment.