• Microsurgical clipping of ruptured anterior circulation aneurysms in good grade patients is generally safe, but almost 10% of them were rendered dependent due to surgical insult alone. 
• A direct vascular injury like intraoperative rupture resulting from faulty clip placement was the culprit in 4%, while another 4% suffered from inadvertent parent vessel inclusion in the clip.
• The use of rigid retractors was faced with direct brain damage leading to brain contusion in 2% of cases emphasizing dynamic retraction as a safer option.
Plain Language Summary 
Bulging or ballooning of the artery due to weakness in the vessel wall that supplies blood to the brain is termed “cerebral aneurysm”. The weakness of the vessel wall is prone to rupture, leading to blood spreading in subarachnoid space, which may extend to adjacent parenchyma and/or ventricles and can be life-threatening. The carotid artery and vertebral artery on each side are the chief vessels supplying blood to the brain. The carotid system is referred to as anterior circulation, while the vertebral system makes posterior circulation. The affected patients are usually in their fourth to sixth decade of life with a female preponderance. Acute rupture calls for intensive care admission, stabilization, and assessment regarding the severity of the bleeding. This assessment involves clinical examination as well as imaging like brain scan and angiography of brain vessels. Patients are then graded according to their clinical well-being as good, bad, or worse. Cerebral angiography helps define that whether the affected vessel belongs to anterior or posterior circulation. It also provides a roadmap to select the treatment modality best suited for an individual case. Both open surgery and endovascular treatment options exist for most cases. Although open surgery is invasive, clipping the neck of an aneurysm is the definitive treatment. Good-grade patients of anterior circulation ruptured aneurysms, who have no pre-operative focal neurological deficits (WFNS I & II), are expected to stay independent following clipping, but oftentimes they do not. Here, we aim to look at the surgical risk factors leading to developing dependency in previously independent patients, thereby focusing only on the impact of surgical expertise available in a resource-limited setup. Vascular injuries in the form of parent vessel occlusion leading to early infarct, intraoperative rupture, and direct brain damage due to rigid retractor were the culprits.