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Background. Intracranial aneurysm serves as a prevalent cerebral disorder leading to the low-quality life and financial burden of the patients. Flow diversion and coil embolization have been confirmed as common therapeutic strategies for intracranial aneurysms. In this work, we identified and compared the cost between the flow diversion and coil embolization in the treatment of intracranial aneurysms in a meta-analysis. Methods. We downloaded literatures that are published before Feb 2021 from Cochrane Library, Embase, and Pubmed using terms including “flow diversion”, “pipeline embolization device”, “coil embolization”, “coiling”, “Intracranial aneurysms”, and “Cerebral aneurysms”. The data were analyzed by STATA 15.1. Differences in treatment costs were determined by WMD (95% CI). Results. A total of 1332 articles were included in the search of the limited terms, and 8 were selected after eliminating duplicate and unwanted studies. Our data indicated that the total cost of flow diversion for intracranial aneurysms is significantly lower than coil embolization ( WMD = − 4419.12 , 95% CI: -6292.21 to -2546.03, p ≤ 0.001 ). In addition, we explored the retreatment hospitalization cost of flow diversion and coil embolization for intracranial aneurysms. We found that the retreatment hospitalization cost of flow diversion for intracranial aneurysms is significantly higher than coil embolization ( WMD = 3203.85 , 95% CI: 1904.60 to 4503.10, p ≤ 0.001 ). Conclusion. We concluded that the total cost was lower, and the retreatment hospitalization costs of flow diversion were higher than coil embolization for the treatment of intracranial aneurysms. Our finding provides valuable insights into the application of flow diversion and coil embolization in intracranial aneurysm therapy. Flow diversion may be applied as a major treatment with the consideration of retreatment.