Delayed ischaemic deficits induced by cerebral arterial vasospasm are the most common postbleed complications and are the most important causes of death and severe disability in patients with subarachnoid haemorrhage. In spite of extensive clinical and experimental investigations in recent years, the basic pathophysiology of cerebral arterial vasospasm after subarachnoid haemorrhage remains uncertain, and treatment modalities for symptomatic cerebral arterial vasospasm are controversial. Successful treatment has been achieved with a wide variety of drug and interventional regimens. However, few of these preventive and therapeutic strategies have been evaluated in prospective, randomized, controlled trials. The therapeutic approaches for delayed neurological complications due to cerebral vasospasm after subarachnoid haemorrhage include haemodynamic augmentation, balloon dilatation angioplasty, intra-aortic balloon counterpulsation, and the use of drugs such as calcium-channel blockers, antioxidants, thrombolytic agents, endothelin receptor antagonists and papaverine. In the absence of firm guidelines for the clinician about postoperative treatment strategies, a graded treatment protocol in which volume expansion and induced hypertension are the mainstays is presented.