Endovascular treatment is suggested as a useful intervention for distal posterior inferior cerebellar artery (PICA) aneurysms due to the anatomical environment specific to these aneurysms that can develop deep under the posterior fossa and are therefore associated with a higher risk of craniotomy. This study considered patients who received endovascular treatment for distal PICA aneurysms in our hospital. Thirteen patients with ruptured aneurysms were treated, including patients with saccular (n=8) and dissecting (n=5) aneurysms. Intra-aneurysmal embolization and parent artery occlusion were performed in seven and six patients, respectively. Radiological outcomes immediately after treatment included: complete occlusion (n=6; 46.2%), neck remnant (n=4), and body filling (n=3). Patients with complete occlusion increased to 11 (91.7%) during the follow-up period. Surgical complications included two intraoperative ruptures and four cerebellar infarctions resulting from parent artery occlusion. The Modified Rankin Scale score was good overall during follow-up: 0 in nine patients, 1 in two patients, 2 in one patient, and 6 in one patient. One patient had a recurrent aneurysm and required additional coil embolization. Re-bleeding was not observed during follow-up. These results further support coil embolization as an effective treatment for aneurysms and favorable patient prognosis in patients with distal PICA aneurysm.