Minimally invasive neurosurgery has significantly evolved over the last several decades. This is due to the improvement of neurodiagnostics, microneurosurgical techniques, neuroanesthesiology and intraoperative imaging. Aim - authors present the results of the use of minimally invasive surgery (MIS) in cerebral aneurysms. In the period 2013-2017, we used 4 minimally invasive approaches in 240 patients with 246 aneurysms. The choice of surgical approach was determined after a thorough evaluation of the intracranial structures and aneurysms. We retrospectively evaluated outcomes, postoperative complications and cosmetic result after MIS. On average, the catamnesis was 6-12 months. Mortality, disability or serious permanent approach-related complications in our group have not been noted. All patients had expected periorbital edema, which was not regarded as a complication. Postoperative cosmetic result was assessed by patients as excellent. Minimally invasive surgery with adequate selection of patients is a safe and effective alternative to traditional approaches in cerebral aneurysm surgery. Rapid recovery of patients and a reduction in the duration of inpatient treatment with the possibility of fast social and labor adaptation after complex neurosurgical interventions is a priority necessity today.