Abstract: Objective To explore the effect of minimally invasive procedure for removal of intracranial hematoma in the treatment of small hypertensive intracerebral hemorrhage in putamen. Methods A total of 80 patients with small hypertensive intracerebral hemorrhage in putamen were randomly assigned to observation group(n=40) and control group(n=40).The control group received the conservative treatment,while the observation group received minimally invasive procedure for removal of intracranial hematoma in addition to the conservative treatment.The remaining hematoma volume and edema volume around the hematoma and efficiency and neurologic impairment score on the first day,the first week,second week and third week,the significant efficiency on third week,and the difference of activity of daily living on third month were compared between the two groups. Results There was significant difference in remaining hematoma volume and edema volume around the hematoma between the two groups on the first day,the first week,second week and third week after treatment(P＜0.01) ;There was difference in neurologic impairment score between the two groups on the first day,the first week,second week and third week after treatment(P＜0.01);There was significant difference of efficiency between the two groups on the third week after the treatment(P＜0.05);There was significant difference of the cure rate of activity of daily living between the two groups on the third week after the treatment(P＜0.05). Conclusion The minimally invasive procedure for removal of intracranial hematoma can quickly remove the intracranial hematoma,relieve brain edema,improve neurologic impairment,and improve the patient’s quality of life.The curative effect is superior to the internal medicine conservative treatment,and is a relatively safe and effective treatment for small hypertensive intracerebral hemorrhage in putamen.