Objective To investigate the influencing factors of intracranial aneurysm related oculomotor nerve palsy (OMNP). Methods A retrospective study was used to analyze the clinical data of 162 patients with intracranial aneurysm. Their data were recorded, including gender, age, history of OMNP, degree of OMNP, information of the aneurysm (side, site, diameter, and time from symptom onset to treatment), and presence of high blood pressure and other systemic diseases. SPSS statistics 20.0 was used for data analysis. Univariate and multivariate analysis were employed for the analysis of the influencing factors of OMNP, chi-square test for analysis of binary data, and non-parametric test for analysis of ranked data. A receiver operating characteristic (ROC) curve was used to calculate the cut-off point of the diameter of intracranial aneurysm affecting OMNP. Multivariate logistic regression analysis was performed. Results In 162 cases of intracranial aneurysm, 40(24.7%) had OMNP, including 24(14.8%) of complete OMNP and 16(9.9%) of incomplete OMNP. The univariate analysis showed that gender, site and diameter of aneurysm affected occurrence of intracranial aneurysm-related OMNP, the difference being statistically significant (P＜0.05). Multivariate logistic regression analysis showed that posterior communicating aneurysms (OR=10.32, P＜0.01) and diameter ≥6mm (OR=10.20, P＜0.01) were influencing factors of OMNP. Conclusion The site and diameter of intracranial aneurysm are influencing factor of OMNP.