The long-term outcome in 26 patients following operation of intracranial saccular aneurysms before the age of twenty is presented. The duration of follow-up ranged from 4 to 33 years (mean 14 years). The oldest patient is now 51 years old. 19 patients (73%) made a complete or good recovery with resumption of normal life. Only one patient was severely disabled and dependent for daily support. Aspects of social outcome such as working conditions and family relationships were encouraging. No association between presence of vasospasm in the acute phase of the disease and the long-term outcome was demonstrated. In one case rupture of a previously undetected aneurysm had occurred during the followed-up period.