Background: In aneurysms overall, a lower rate of recanalization in stent assisted coiling vs coiling alone has been observed without an increase in morbidity. This study aims to stratify and compare degree of occlusion outcome by treatment modalities. Secondarily, this study aims to stratify and compare postoperative adverse events. Methods: MEDLINE and EMBASE databases were searched. Study center were reviewed for inclusion. We performed meta-regressions, bias analysis and fail-safe N. We controlled for the quality of the studies. Results: 396 nonduplicated patients were separated into 4 groups: microsurgical, stent-assisted coiling, coiling, stent only. Stent-assisted coiling has lower rate of retreatment (17 vs 24%) and higher rehemorrhage (5% vs 3%) compared to coiling. Stent-assisted has higher rates of complete occlusion (55% vs 45%) and lower rate of residual aneurysm (15% vs 23%) compared to coiling. Comparative analyses were performed. Microsurgical remained the most morbid modality with the best rate of complete occlusion (93%) and lowest rehemorrhage (2%) and retreatment rate (5%). Conclusions: This is the first and largest meta-analysis focusing on patients treated for basilar apex aneurysm. To our knowledge, this is the first study to stratify and compare degree of occlusion per treatment modality. This study provides benchmark numbers to guide clinicians.