Objective To compare rotational DSA with routine DSA in the assessment of intracranial aneurysms. Methods Conventional anteroposterior, lateral and oblique views of DSA and rotational DSA were respectively performed in 20 patients suspected of intracranial aneurysms in subarachnoid hemorrhage using DSA (Philips Integris V 3000DSA system). Images were compared for localization of the aneurysm, shape of the aneurysmal neck and vascular branch anatomy. Results Among 20 patients, only 18 intracranial aueurysms were found by convertional DSA and the other two were only by the rotational DSA. Furthermore, conventional DSA examination could not clarify the relationships of 6 (6/18) aneruysms with their parent arteries and with the vascular branch anatomy including the aneurysmal neck could not be clarified in 7 (7/18) patients. However, shape of the aneurysms and visibility of the aneurysmal neck could be clarified after using the rotational DSA, and meanwhile, vascular anatomy can be indentified with the rotational DSA. Conclusion Rotational DSA often allows better visibility of vascular anatomy and aneurysmal neck compared with conventional DSA, offering more important information for operation.