Rapid and continuous progression in the field of interventional neuroradiology (INR) has allowed many surgically difficult cranial vascular lesions to be treated effectively and less invasively. Development of high-resolution fluoroscopy and digital subtraction angiography also contributed to expansion of the role of the INR. The spectrum of INR application includes intracranial and extracranial stenosis, aneurysms, arteriovenous malformations, hypervascular tumors, and bleeding. Introduction of new devices and materials is so rapid that it is difficult to get outcome evaluation and reimbursement by the insurance which requires a long period of process. Role changes of the physicians and the hospitals seem to be considered for the patients who had required difficult surgery and perioperative surgical management.