Cerebral hemorrhage often causes intracranial hypertension because of the occupying effect of the hematoma, and if conservative medical treatment is not effective, surgical treatment should be chosen. The aim of surgical treatment is to remove the hematoma, reduce the intracranial pressure and save lives. The surgical options are open hematoma removal, debridement decompression, borehole hematoma aspiration, or ventricular puncture and drainage. The current decision on the timing and method of surgery is generally based on the site of bleeding, etiology, amount of bleeding, patient age, state of consciousness, and general condition. Usually, surgical treatment should be started in the following cases: first, bleeding in the basal ganglia area is more than 30 ml, and bleeding in the thalamus is more than 15 ml. Second, cerebellar hemorrhage greater than 10 ml or greater than 3 cm in diameter and accompanied by significant hydrocephalus. Third, severe ventricular hemorrhage with castellated changes in the ventricles. All of them are indications for surgical treatment.