Three dimensional (3D) reconstruction techniques providing volume rendered 3D images from rotational angiography data now exist.We report the design and early experience with one such system. 237 aneurysms were studied. Information was obtained on the morphology of the aneurysm itself and the vascular architecture in and around the aneurysm. 218 (92%) aneurysms went on to have endovascular treatment. The 3D images provided valuable information on aneurysmal anatomy, including relationships with the parent and adjacent vessels. This technique allowed fast and safe decision-making regarding the feasibility of endovascular or surgical treatment and provided useful information for performing the chosen treatment.