Abstract: Objective To analyze the effect of hematoma removal and decompressive craniectomy in the treatment of hypertensive cerebral hemorrhage. Methods A total of 85 patients with hypertensive cerebral hemorrhage in our hospital were selected as study objects, and were divided into two groups by random ball touch method. The control group(n=42)was conducted simple hematoma removal method, while the observation group(n=43)was treated with hematoma removal combined with decompressive craniectomy, and the effects of two different treatment methods were compared. Results The total clinical effective rate of the observation group was 97.67%(42/43), which was higher than 83.33%(35/42)of the control group, the difference was statistically significant(P<0.05). The good and excellent rate of quality of life of the observation group was 97.67%(42/43), which was higher than 80.95%(34/42)of the control group, and the difference was statistically significant(P<0.05). The neurological function scores at 1, 3 week after treatment of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Hematoma removal combined with decompressive craniectomy can effectively improve the therapeutic effects, and enhance the neurological deficit.