Intracranial hemorrhage is a common cause of acute cerebrovascular disease with a high mortality and disability rate. Minimally invasive hematoma removal for intracranial hemorrhage is now receiving increasing attention in neurology. For patients with aggressive onset and obvious brain herniation, immediate surgery should be performed for timely decompression and release of brain herniation. Early stage (12 h～5 d): Although the efficacy of ultra-early surgery has been reported to be better than early or postponed surgery, we believe that the greatest advantage of minimally invasive technique treatment is easy operation and small trauma, and it is a limitation that the surgery is performed under non-direct vision of the hematoma and cannot effectively stop the bleeding. The hematoma has already coagulated and the cerebral edema is not too heavy 12 h to 5 d after the onset of the disease, so surgery at this time is less likely to rebleed and has good results. The results of our clinical application also confirm this. Delayed ( > 5 d): At this time, the brain tissue around the hematoma is damaged and the cerebral edema is heavy, and there are many systemic complications, so the efficacy is poor. Indications and methods: hypertensive supratentorial parenchymal hemorrhage with onset > 12 h and hematoma > 30 ml , perform drilled cranial hematoma fragmentation and aspiration; cerebellar hemorrhage and subarachnoid hemorrhage with acute hydrocephalus, perform unilateral extraventricular drainage to resolve supratentorial hydrocephalus; primary or secondary ventricular hemorrhage, apply extraventricular drainage. Traditionally, the side containing less blood (healthy side) is chosen for extraventricular drainage, mostly because the blood on the healthy side is relatively small, non-coagulable and easy to drain; liquefaction can also be applied to drain the affected side (intracerebroventricular injection of urokinase, 1 time/d, 2-6 u each time), because the primary lesion is in the brain parenchyma, plus the continuous secretion of cerebrospinal fluid and drainage of the liquefied blood. The results of clinical application confirm that older age, more complications, and severe impairment of consciousness are not absolute contraindications to minimally invasive surgery. Minimally invasive hematoma removal for intracranial hemorrhage is simple, less invasive, can remove the hemorrhage early, effectively prevent and stop the complications caused by hematoma and cerebral edema, significantly increase the survival rate, improve the quality of life of patients, and greatly reduce the death and disability rate of intracranial hemorrhage. This technique is carried out in the Department of Neurology and is managed by neurologists and nurses throughout the preoperative and postoperative periods, which is conducive to emergency care, systematic treatment and rehabilitation of patients.