Abstract: Objective To compare the effect of minimally invasive soft channel puncture as well as drainage and removal of hematoma by craniotomy in the treatment of hypertensive intracerebral hemorrhage. Methods Totally 116 patients with hypertensive intracerebral hemorrhage were divided into control group and observation group by blind selection method, with 58 cases in each group. The control group was treated with removal of hematoma by craniotomy, and the observation group was treated with minimally invasive soft channel puncture and drainage. The operation related indexes, score of Barthel index and incidence of complications were compared between the two groups. Results The operation time, hematoma clearance time and cerebrospinal fluid recovery time in the observation group were significantly shorter than those in the control group(P<0.05). The scores of Barthel index in the observation group at 1 month, 3 and 6 months after operation were significantly lower than those in the control group(P<0.05). The incidence of complications in the observation group was 6.90%, which was significantly lower than 20.69% in the control group(P<0.05). Conclusion Minimally invasive soft channel puncture and drainage is effective in the treatment of hypertensive intracerebral hemorrhage, which can shorten operation time, reduce blood loss, accelerate postoperative recovery and reduce incidence of complications.