The mortality rate of medical treatment of hypertensive cerebral hemorrhage is high, 50-90%. Surgical treatment is more effective, with an operative mortality rate of 2-28% and a functional recovery rate of 63-89%. Surgery should be performed early, i.e. within 24 to 48 hours after the onset of the disease. Ultra-early surgery, i.e., within 7 hours of cerebral hemorrhage, is more effective. Early removal of the hematoma, microscopic removal of the hematoma and bipolar electrocoagulation can make the operation more delicate and accurate, minimize the damage and reduce the intracranial pressure, which not only can achieve the purpose of saving lives, but also help to promote the recovery of brain function and reduce disability. Surgical treatment criteria for hypertensive cerebral hemorrhage: 1. Supratentorial (cerebral hemispheres) hematoma volume > 30 ml, with or without cerebellar curtain incision herniation (cerebral herniation). 2. Subscallosal (cerebellar hemisphere) hematoma volume >15ml, with or without obstructive hydrocephalus. 3. Ventricular hemorrhage forming a ventricular cast with obstructed cerebrospinal fluid circulation. Timing of surgical intervention: 1. When conservative treatment by internal medicine is ineffective and the condition gradually worsens, active treatment should be sought before irreversible damage to brain tissue is suffered. 2.The amount of hematoma reaches the indication of surgery, and the patient should be actively treated if he is comatose but does not develop cerebellar curtain incisional herniation. 3. If the amount of hematoma reaches the indication for surgery and the presence of herniation of the cerebellar curtain, the patient should be treated more actively. The choice of surgical methods: conventional flap craniotomy, small bone window craniotomy, minimally invasive or stereotactic aspiration and drainage. Advantages of conventional flap craniotomy: complete removal of the hematoma; adequate decompression; complete hemostasis under good direct vision; timely elimination of the compression of the hematoma on the surrounding brain tissues; suspension of the stimulating and damaging effects on brain tissues after hematoma dissolution; removal of the bone flap minimizes the damage of postoperative cerebral edema. Advantages of minimally invasive surgery: minimal trauma to normal brain tissue (minimally invasive), no need for major efforts; short operation time, often only 0.5-1 hour; simple operation, only a special hematoma puncture needle with some necessary surgical equipment; high safety factor; less patient pain and fewer complications. In recent years, some new treatment methods have been adopted in the treatment of cerebral hemorrhage. For example, cranial drilling is performed to inject urokinase into the hematoma cavity to promote the liquefaction of the clot, and then it is aspirated. This method is simple and easy to perform, and its efficacy is confirmed. In addition, cT-guided brain stereotactic removal of hematoma and CT localization and endoscopic removal of hematoma have also been developed. These treatment modalities are not only less invasive, but also have better efficacy.