Puncture and aspiration therapy for hypertensive cerebral hemorrhage has become one of the main means of treating hypertensive cerebral hemorrhage, especially in primary hospitals or in the case of emergency patients, rapid and precise localization techniques play a rather important role in improving the accuracy of puncture and surgical efficacy. In order to achieve accurate localization, a variety of body surface localization techniques based on the principle of stereotacticity have been emerging. These techniques play an important role in improving the accuracy of puncture, but there are some limitations: ① Often need to place the body surface markers, and must be scanned again by CT scanning in order to become a localization process. ② The structure of some localizers is more complex, close to the old stereotactic apparatus, and it is difficult to make them by oneself, while the simple right-angle localization plate adopts visual positioning, and there may still be a large error in the large curvature of the skull surface. (iii) Certain unarmed body positioning methods are cumbersome in calculation and operation, and the lack of reference on the body surface has a certain degree of blindness. On the basis of reference to a variety of domestic and foreign counterparts in the puncture positioning method, after summarizing our own experience in puncture over the years, and constantly revised, improved and perfected, we are currently using the “one-line, two-point localization, vertical brain surface puncture method”, which is simple and easy to learn, accurate positioning, and is worth promoting. The “one-line, two-point localization, vertical brain surface puncture method” is a freehand localization method, which requires only a minute gauge and a special localization ruler, which can also be replaced by an ordinary tape measure. According to the need to avoid the functional area or dense cerebrovascular area (3cm around the wing point), and according to the characteristics of the hematoma shape, the optimal puncture path can be selected to obtain a higher hematoma removal efficiency. Specific operational steps: 1. Determine the baseline of the CT scan. Determine the distance between the largest level of the lesion and the baseline of the CT scan. Measure the distance from the proposed puncture point to the midline point on the CT film. 4. Measure the distance from the proposed puncture point to the proposed target point on the CT film. 5. Turn the above measurements on the CT slice into the real distance and restore it to the surface of the skull. 6. Drill, puncture, and feed the needle perpendicular to the brain surface. The key to puncture accuracy lies in the body surface marking of the baseline. How to restore the baseline and lesion of CT scan to the patient’s skull surface accurately at the maximum level is the key point we need to master. For patients who are scanned strictly according to the bared-auricular line during CT scanning, it is relatively easy to accurately mark and delineate. However, for CT slices not scanned in the standard plane, the following principles must be followed: ① Determine the baseline according to the anatomical markers on the side of the puncture, and the anatomical markers usually used are the eyeball and the bony ear canal. When the anatomical markers are not at the same level, the comparison is based on the level difference between the two. ② Use other anatomical marks on the body surface (e.g., coronal suture, frontal node, parietal node, etc.) to validate the localization point and adjust appropriately according to the results.