Objective To study the causes, emergency managements and preventative measures of intraoperative rupture during embolization of intracranial aneurysms. Methods One hundred and thirty-two patients with intracranial aneurysms and having performed embolization were enrolled. Intraoperative rupture occurred in 6 patients during embolization of intracranial aneurysms. The causes were analyzed and emergency managements were reviewed. Results The causes were as follows: intracranial aneurysms were punctured by microtubular in 2 patients, by spring coil in 1 patient and by guidewire in 1 patient, and intracranial aneurysms were attributed to stent break in 1 patient and blood pressure fluctuation in 1 patient. The rapid embolization were performed, 1 patient underwent craniotomy evacuation of hematoma, 1 patient underwent lateral ventricular drainage, 2 patients underwent lumbar cistern drainage, and 2 patients did not receive any processing. At the discharge from hospital, 2 patients recovered well, 1 patient showed mild paralysis, 1 patient had severe disability, and 2 patients died. Conclusions Intraoperative rupture during embolization of intracranial aneurysms is the life-threatening complication and mainly relates to operation, structure of aneurysm, blood pressure fluctuation during operation. The prognosis depends on the extent of bleeding and appropriate treatment without delay.