Abstract: Objective To explore the effect of adjustable assisted sheath assisted neuroendoscopic treatment for spontaneous hypertensive cerebral hemorrhage. Methods Sixty-four patients with spontaneous cerebral hemorrhage were divided into sheath group and no sheath group according to whether or not the auxiliary sheath was used. The basic information of the two groups at admission was recorded, and the comparison before and after surgery and the short-term and long-term prognosis of the two groups were observed. Results There was no significant difference in the basic conditions of the two groups before surgery(P>0.05). The amount of postoperative hematoma in the sheath group was significantly reduced compared with before operation(P<0.05). The short-term prognosis results showed that the sheath group had higher hematoma clearance rate than the no sheath group, and the difference was statistically significant(P<0.05). Long-term prognostic results showed the Glasgow Outcome Scale(GOS)score was higher in patients with preoperative Glasgow coma scale(GCS)scores of 3 to 8 in the sheath group than the no sheath group, the Barthel index(BI), and the modified Rankin Scale(mRS)scores were lower than the no sheathed group, and the differences were statistically significant(P<0.05). Conclusion The new adjustable auxiliary sheath has obvious advantages in neuroendoscopic treatment of spontaneous hypertensive cerebral hemorrhage, which can improve the neurological function and prognosis of patients.