Objective To evaluate the clinical effectiveness of perioperative anesthesia management based on enhanced recovery after surgery (ERAS) for clipping of the intracranial anterior circulation aneurysm. Methods A total of 130 patients, including 56 men and 74 women, aged 18‒64 years, with body mass index (BMI) at 18‒30 kg/m2, at American Society of Anesthesiologists (ASA) Ⅰ‒Ⅲ, Hunt‑Hess 0‒Ⅱ, who were scheduled for clipping of the anterior intracranial circulation aneurysm under general anesthesia were selected. According to the inclusion time, the patients were divided into two groups (n=65): an ERAS group (group E, from July 2019 to April 2021) and a control group (group C, from July 2018 to Jun 2019). Group E was subject to perioperative anesthesia management for ERAS, while group C underwent routine anesthesia management. Their length of postoperative hospitalization stay, hospitalization expense, intraoperative characteristics, postoperative recovery, and the Numeric Rating Scales (NRS) scores at postoperative 2, 4, 8, 12, 18, 24 and 48 h, and analgesia were recorded. The incidence of complications, patient satisfaction toward clinical services at discharge, Karnofsky Performance Scale (KPS) score at week four of follow‑up period after discharge, and readmission events were recorded. Results Compared with group C, group E showed shortened length of postoperative hospitalization stay (P<0.05) and reduced hospitalization expense (P<0.05), as well as remarkable decreases in intraoperative lens input, sufentanil and remifentanil doses (all P<0.05), NRS scores at postoperative 2, 4, 8, 12, 18, 24 and 48 h (all P<0.05), the number of effective and total compressions of patient controlled analgesia (PCA) pump and the number of remedial analgesia cases (all P<0.05), and decreases in the time to urinary catheter removal, time to first out‑of‑bed activity, and time to first feeding (all P<0.05), with a reduced incidence of deep vein thrombosis (DVT) (P<0.05). There was no statistical difference in other intraoperative indicators, other complications and KPS score at week four of follow‑up period after discharge between the two groups (all P>0.05). Patient satisfaction toward clinical service after discharge was 100% and no readmission event was reported in the two groups. Conclusions Clipping of the intracranial anterior circulation aneurysm through multi‑directional perioperative anesthesia management based on ERAS can shorten the length of postoperative hospitalization stay, reduce hospitalization expense, postoperative pain scores and the incidence of postoperative complications, and improve the quality of postoperative recovery.