Aneurysmal subarachnoid haemorrhage (aSAH) is a neurovascular emergency with significant morbidity and mortality. Advances in imaging, endovascular treatments, and neurocritical care have improved outcomes. Early intervention is critical to prevent secondary brain injury and systemic complications. Multidisciplinary care, including standardised neurological assessments, transcranial Doppler (TCD), and advanced imaging, is essential. Health disparities in SAH treatment affect outcomes, and telemedicine and novel technologies are proposed to address these inequalities. SAH occurs in approximately 8 per 100,000 people in the UK, with a higher incidence in women. The most common cause is the rupture of an intracranial aneurysm, accounting for 80-85% of cases. aSAH leads to substantial morbidity, mortality, and healthcare burden. The prognosis varies, with factors such as age, aneurysm size, and initial neurological status influencing outcomes. Survival has improved due to early diagnosis and treatment. Diagnosis involves CT scans, which are highly sensitive and specific within the first 6 hours of symptom onset. CTA is the first investigation, followed by DSA if results are inconclusive. MRA is an alternative for patients allergic to iodine. Early securement of the aneurysm within 72 hours is crucial to prevent rebleeding. Treatment options include coiling and clipping, with coiling preferred for improved outcomes. Management includes maintaining cerebral perfusion pressure, treating hydrocephalus, seizures, and vasospasm. Nimodipine is the only proven standard neurotherapeutic regimen for preventing and treating cerebral vasospasm and delayed cerebral ischemia (DCI). Other interventions include induced hypertension and endovascular treatment. Multimodality monitoring, such as brain tissue oxygenation and cerebral perfusion pressure, is essential for managing DCI. Medical complications, including infections, anaemia, and hyponatraemia, are common in aSAH. Cardiopulmonary complications, such as myocardial injury and arrhythmias, are also frequent. Fever and hypoglycaemia can worsen outcomes. Management strategies include maintaining normoglycaemia, preventing hypoxia, and using antipyretics. Inequalities in healthcare access significantly impact SAH outcomes. Telemedicine and novel technologies can help address these disparities. Large-scale studies are needed to establish standardised treatment protocols and improve outcomes. Future research should focus on refining treatment protocols and developing innovative approaches to manage SAH. Collaboration between neuroscientists, clinicians, and health policy experts is crucial for advancing SAH management.Aneurysmal subarachnoid haemorrhage (aSAH) is a neurovascular emergency with significant morbidity and mortality. Advances in imaging, endovascular treatments, and neurocritical care have improved outcomes. Early intervention is critical to prevent secondary brain injury and systemic complications. Multidisciplinary care, including standardised neurological assessments, transcranial Doppler (TCD), and advanced imaging, is essential. Health disparities in SAH treatment affect outcomes, and telemedicine and novel technologies are proposed to address these inequalities. SAH occurs in approximately 8 per 100,000 people in the UK, with a higher incidence in women. The most common cause is the rupture of an intracranial aneurysm, accounting for 80-85% of cases. aSAH leads to substantial morbidity, mortality, and healthcare burden. The prognosis varies, with factors such as age, aneurysm size, and initial neurological status influencing outcomes. Survival has improved due to early diagnosis and treatment. Diagnosis involves CT scans, which are highly sensitive and specific within the first 6 hours of symptom onset. CTA is the first investigation, followed by DSA if results are inconclusive. MRA is an alternative for patients allergic to iodine. Early securement of the aneurysm within 72 hours is crucial to prevent rebleeding. Treatment options include coiling and clipping, with coiling preferred for improved outcomes. Management includes maintaining cerebral perfusion pressure, treating hydrocephalus, seizures, and vasospasm. Nimodipine is the only proven standard neurotherapeutic regimen for preventing and treating cerebral vasospasm and delayed cerebral ischemia (DCI). Other interventions include induced hypertension and endovascular treatment. Multimodality monitoring, such as brain tissue oxygenation and cerebral perfusion pressure, is essential for managing DCI. Medical complications, including infections, anaemia, and hyponatraemia, are common in aSAH. Cardiopulmonary complications, such as myocardial injury and arrhythmias, are also frequent. Fever and hypoglycaemia can worsen outcomes. Management strategies include maintaining normoglycaemia, preventing hypoxia, and using antipyretics. Inequalities in healthcare access significantly impact SAH outcomes. Telemedicine and novel technologies can help address these disparities. Large-scale studies are needed to establish standardised treatment protocols and improve outcomes. Future research should focus on refining treatment protocols and developing innovative approaches to manage SAH. Collaboration between neuroscientists, clinicians, and health policy experts is crucial for advancing SAH management.