The options for treating unruptured aneurysms in elderly patients have increased, and are discussed herein. We statistically analyzed the outcomes of 69 unruptured aneurysms in patients aged under 75 and over 76 years old treated between October 2013 and March 2016. Treatment in those under 75 years old resulted in modified Rankin Scale (mRS) scores of 0-1. In contrast, treatment in those over 76 years old resulted in mRS scores of 4 in 1 patient with a cerebral infarction and 1 with a cerebral hemorrhage (40%, 2/5) (p<0.05). An aneurysm in a 79-year-old was treated with refuge embolization, and she is now well. We conclude that unruptured aneurysms in patients over 76 years old should be managed carefully. If necessary, refuge coil embolization is an option.