Patients treated at the Center of Neurosurgery in Tashkent over the period of 2015-2021. Follow-up by mailing medical questionnaires or telephone interviews was collected from 94 (82 %) of 115 patients. The mean follow-up period was 38.2±28.0 months. The mean age of the patients at the time of surgery was 42.55±8.5 years, at the time of follow-up assessment was 49.4±9.8 years. There were 67 men (58.3 %), women - 48 (41.7%). The radicality of surgical treatment of aneurysms was 97.4% (112 patients). Results. Depending on the variations of the clinical course of large and giant aneurysms, cerebral (30.43% of patients), focal symptoms (34.78% of patients) and meningeal symptoms significantly prevailed in the studied patients. With regard to motor defects, a similar trend was noted: only 12 (10.43%) patients with mild paresis noted the recovery of movements. In 6 (5.3%) patients discharged with moderate and severe paresis, noticeable regression was not noted. The results of treatment can be assessed as successful: favorable outcomes on the Glasgow Outcome Scale (GOS) 4 and 5 were obtained in 99 (86.08%) patients; satisfactory (GOS 3), which means the presence of a severe neurological defect, in 12 (10.43%); there were no outcomes to a vegetative state (GOS 2). Conclusions. Despite the successful use of modern endovascular techniques for the treatment of large and giant aneurysms in recent years, direct microsurgical interventions do not lose their relevance. Clipping of aneurysms, as our work has shown, remains a highly effective radical treatment for patients with large and giant aneurysms with favorable early and long-term results