Due to the wide application of noninvasive angiography in the health examination or central nervous system disease treatment, more and more pilots with asymptomatic and unruptured intracranial aneurysms (UIAs) have been found. Most asymptomatic UIAs are still in "static phase" for a long time, but a few of them can grow gradually, even rupture and bleed suddenly,which may have the risk of disability in the sky. The risk factors of rupture for UIAs include patient's factors, aneurysm's factors,hemodynamics and flight related factors. Interventions include medical treatment, intracranial aneurysm clipping and endovascular treatment. The selection of the treatments need to weigh the risk of aneurysm rupture and surgical complications of UIAs. At present, there are no opinions and aeromedical evaluation criteria for asymptomatic UIAs in pilots nationally and internationally.Therefore, it is necessary to conduct multidisciplinary and individual assessment.