Objective To analyzed the risk factors and clinical features of ischemic complication (IC) in the endovascular treatment (EVT) of unruptured intracranial aneurysm (UIA), so as to reduce the incidence of IC. Methods We retrospectively analyzed the clinical and imaging features of 1 232 patients with UIA, who received EVT in Changhai Hospital, Second Military Medical University from Jan. 2010 to Feb. 2017. Univariate and multivariate analyses were performed to analyze the risk factors of IC. Results IC occurred in 34 (2.8%) of 1 232 patients with UIA in this study, including 16 cases of acute stent thrombus formation, 3 cases of transient ischemic attack, and 15 cases of post-operative cerebral infarction. Univariate analysis showed that hypertension (P=0.002), smoking (P=0.050), and aneurysm maximum diameter>10 mm (P=0.005) were associated with IC. Multivariate analysis showed that hypertension (OR=3.192, P=0.003), smoking (OR=2.956, P=0.022) and aneurysm maximum diameter>10 mm (OR=2.915, P=0.004) were independent risk factors of IC. The permanent disability rate and mortality rate of IC were 8.8% (3/34) and 2.9% (1/34), respectively. Conclusion Hypertension, smoking and aneurysm maximum diameter>10 mm are independent risk factors of IC in the EVT of UIA.