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Between May 2008 and July 2017, endovascular treatment of 1184 aneurysms in 827 patients was performed in a single institution. Twenty-four percent of these aneurysms were located at the MCA, and 150 unruptured MCA bifurcation aneurysms treated with coiling, stent-assistedcoiling, or endovascular flow diverter (WEB device) were identified for this retrospective data analysis. The procedure-associated good clinical outcome was 89.9%, and the mortality rate was 2.7%. Short-term follow-up good clinical outcome/mortality rates were 91.3%/0.7%. At discharge, 137 patients had an mRS of 0–2 (91.3%) and 13 had an mRS of 3–6 (8.7%). The authors conclude that regardless of the architecture of MCA bifurcation aneurysms, endovascular treatment can be performed with low morbidity/mortality rates.