IntroductionAneurysm subarachnoid haemorrhage is a leading cause of mortality occurring in about 10 per 100,000 persons annually. It is characterised by three commonly occurring complaints: 'worst headache of my life' , photophobia and meningismus. It is imperative that emergency department and primary care physicians understand how to diagnose and initially manage aneurysm subarachnoid haemorrhage. Discussion This review details cerebrospinal fluid analysis and the current imaging techniques for identifying aneurysm subarachnoid haemorrhage and intracranial aneurysms. It will cover the initial management and treatment options along with considerations in delayed SAH presentation. Conclusion A high suspicion for SAH during the initial evaluation increases the patient's chance for early intervention and reduces mortality and disability.