Objective To analyze the clinical effect and significance of small bone window craniotomy in hypertensive cerebral hemorrhage.Method The modified small bone window hematoma evacuation for treatment of hypertensive cerebral hemorrhage 68 cases clinical data were retrospectively analyzed.Results 28 cases(41.2%) were good recovery,20 cases(29.4%) were moderate disability,12 patients(17.6%) were severe disability,2 cases(2.9%) were plant survival,6 cases(8.8%) were death.Conclusion The modified small bone window craniotomy is better for hypertensive cerebral hemorrhage treatment,and there is a high quality of life,so it is worth for clinical use