Objective:To preliminarily investigate the safety and efficacy of Pipeline embolization device (PED) in the treatment of unruptured intracranial vertebral artery dissecting aneurysm (VADA).Methods:Patients with unruptured intracranial VADA received PED treatment in the Department of Neurosurgery, Xi'an Ninth Hospital from December 2015 to September 2023 were included retrospectively. Their demographic data, vascular risk factors, clinical symptoms, preoperative modified Rankin Scale (mRS) scores, imaging data, and treatment regime were collected. The O'Kelly-Marotta (OKM) grading scale was used to evaluate the occlusion of aneurysms.Results:A total of 18 patients with unruptured intracranial VADA were enrolled, including 12 males (66.7%), aged 37-67 years. All patients successfully completed PED implantation without any periprocedural complications. Six patients (33.3%) were treated with coil-assisted embolization, and 12 (66.7%) were treated with PED implantation alone. Digital subtraction angiography (DSA) showed contrast retention in aneurysm lumen in 10 patients (55.6%) immediately after surgery. Clinical follow-up was performed in 18 patients, of which the mRS score was 0 in 12 patients (66.7%) and the mRS score was 1 in 6 patients (33.3%). Fifteen patients (88.3%) received DSA follow-up, including 12 (80.0%) with OKM grade D and 3 (20.0%) with grade C, and the posterior inferior cerebellar arteries had smooth blood flow.Conclusion:PED is safe and effective in the treatment of unruptured intracranial VADA.