Objective To analyze the small bone window craniotomy in hypertensive cerebral hemorrhage in the clinical effect.Methods The modified small bone window hematoma evacuation for treatment of hypertensive cerebral hemorrhage 68 cases clinical data were retrospectively analyzed.Results After six months of discharge Glasgow(GCS) score:34 cases(50.00%) as good recovery,15 cases(22.06%) moderate disability,10 patients(14.71%) of severe disability,3 cases(4.41%) for plant survival,6 cases(8.82%) for death.Conclusion The modified small bone window craniotomy is the better of hypertensive cerebral hemorrhage treatment.