The purpose of this study was to compare cost-effectiveness between coiling and clipping in patients with ruptured or unruptured cerebral aneurysms during their hospital stay. The authors conducted a retrospective analysis of patients with cerebral aneurysms that were treated by clipping or coiling at Cerrahpasa Medical Faculty Hospital during a 1-year period. Direct hospital-based costs and physicians' fees were calculated and compared between the 2 groups. A total of 76 patients had clipping, and 65 underwent coiling. There were no differences with regard to age or sex in both groups. When comparing major cost categories between the 2 groups, including laboratory tests, medications, blood and blood derivatives, physicians' fees, surgical/embolization supplies, hospital stay, and imaging, a highly statistically significant difference was found in all major cost categories (P < 0.001). The results showed that although coiling allows a shorter hospital stay and results in a low complication rate, the high cost of single-use medical supplies (eg, coil, microcatheters) increased the cost per patient considerably.