Thalamic hemorrhage with coma indicates that the amount of bleeding may be large, or the patient’s general condition is poor and serious, and life-threatening if not treated promptly. Whether thalamic hemorrhage is dangerous or not depends mainly on the amount of bleeding and the compression of the hematoma on the surrounding tissues. A small amount of thalamic hemorrhage may be accompanied by sensory abnormalities and mild limb movement disorders, and is usually not accompanied by coma. Large thalamic hemorrhages are usually associated with contralateral hemiparesis, hemiplegia, coma in most patients, and the risk of hematoma rupture into the ventricles. A thalamic hemorrhage greater than 15 mL is considered an indication for surgery. Due to the deep location of the thalamus, the hemorrhage causes heavy pressure on the brain tissue, so once the thalamic hemorrhage occurs, it should be actively treated. Surgery should be performed as soon as possible to prevent the hematoma from compressing the brain tissue and brain nerves for a long time and affecting the recovery of neurological function.