Interactive 3D segmentation embodies an advanced human-in-the-loop paradigm, where a model iteratively refines the segmentation of interested objects within a 3D point cloud through user feedback. Existing methods have achieved notable advancements at the expense of substantial resource consumption. To address this challenge, we introduce E$^2$I3D, an efficient and effective model for interactive 3D segmentation. Specifically, we propose a two-stage efficiency-to-effectiveness framework to decouple efficiency and effectiveness, avoiding the high training cost of joint optimization. For efficiency in the first stage, we present heterogeneous pruning, which reliably compresses the model by ranking and pruning the constructed heterogeneous groups separately based on gradient compensation. For effectiveness in the second stage, we design hierarchical click-aware attention that integrates geometric details from high-resolution features with global context from low-resolution features to enhance click-guided interaction. Extensive experiments across public datasets demonstrate that E$^2$I3D exceeds state-of-the-art methods in both efficiency and effectiveness. For instance, on the KITTI-360 dataset, E$^2$I3D boosts the IoU for interactive single-object segmentation from 44.4% to 49.0% with 5 user clicks, while simultaneously reducing parameters from 39.3M to 5.7M.