Background <p>Although subarachnoid hemorrhage–related mortality has decreased in recent years due to improvements in treatment, data on the evolution of 1-year functional outcomes after subarachnoid hemorrhage are lacking. The objective of this study was to evaluate the evolution of patient management and their functional outcomes 1&#xa0;year after subarachnoid hemorrhage over time in a single high-volume neurosurgical intensive care unit.</p> Methods <p>In this observational retrospective study, all consecutive patients with aneurysmal subarachnoid hemorrhage admitted to our neurosurgical intensive care unit between 2002 and 2019 were included. A poor functional outcome was defined as a modified Rankin Scale score of 4–6. Linear regressions were performed, and relative risk reductions of a poor functional outcome were calculated.</p> Results <p>Between 2002 and 2019, 1556 patients were included, of whom 329 (21%) had a poor functional outcome. Over time, the percentage of coiling procedures (<i>p</i> = 0.004) increased, and the percentage of delayed cerebral ischemia (<i>p</i> = 0.03) decreased. One-year mortality decreased over time (<i>p</i> &lt; 0.001), whereas 1-year functional outcome improved (<i>p</i> = 0.002), with a relative risk reduction of poor functional outcomes of 38% (17–54%).</p> Conclusions <p>The 1-year functional outcome of patients with subarachnoid hemorrhage improved between 2002 and 2019, and mortality decreased.</p>