Objective: To investigate morphological risk factors of basilar aneurysm rupture based on computer tomography angiography (CTA) parameters. Materials and methods: The clinical and CTA data of 43 patients with basilar aneurysm admitted to Shaanxi Provincial People’s Hospital from January 2015 to July 2023 were analyzed. The patients were divided into “ruptured group” and “unruptured group,” and the morphological parameters of aneurysms were measured. The general data and morphological parameters between the two groups were statistically analyzed. Logistic regression was used to analyzed statistically significant parameters, and the receiver operating characteristic curve was drawn to evaluate its diagnostic effectiveness. Results: Irregular aneurysms were more likely to rupture than regular aneurysms (x² = 13.971, P < 0.05). The maximum diameter (4.92 [3.37–6.94] mm), length-width ratio (1.31 [1.14–1.55]), height (4.08 [2.71–5.34] mm), aspect ratio (0.99 [0.84–1.45]), and inflow angle (133.63 ± 11.21°) of aneurysms in the ruptured group were larger than the unruptured group, and the differences were statistically significant (P < 0.05). Binary logistic regression showedthat aneurysm shape (OR = 39.347, P = 0.021), length-width ratio (OR = 313.062, P = 0.033), and inflow angle (OR = 1.156, P = 0.004) were independent risk factors for rupture. The area under the curve were 0.809, 0.842. and 0.894, respectively. Conclusion: Aneurysm shape, aspect ratio, and blood flow incidence angle are independent risk factors for basilar aneurysm rupture, which means that they can be used to predict the risk of rupture to a certain extent.