Abstract: Objective To observe the clinical effect of early minimally invasive puncture and drainage in the treatment of hypertensive basal ganglia cerebral hemorrhage. Methods Clinical data of 72 patients with hypertensive basal ganglia hemorrhage was retrospectively analyzed, and they were divided into control group(n=30)and observation group(n=42)according to different treatment plans. The control group used conservative drug therapy, and implemented removal of hematoma necessarily. The observation group was given early minimally invasive puncture and drainage treatment. The efficacy, edema zone changes, National Institutes of Health Stroke Scale(NIHSS)score of neurological function and prognosis of the two groups were compared. Results The hematoma clearance rate of the observation group was significantly higher, and the rate of re-bleeding and incidence of complications were significantly lower than those of the control group(P<0.05). There was no significant difference in mortality rate between the two groups(P>0.05). The edema zone of the control group at 1, 4, 7 and 10 d after treatment was increased, which showed significant difference compared with that at admission(P<0.05), while was significantly reduced in the observation group at 1, 4, 7 and 10 d after treatment compared with treatment before(P<0.05), and there was also a significant difference between the observation group and the control group after treatment in the same time points(P<0.05). NIHSS scores in the observation group at 1 month and 3 months after treatment were significantly lower than those in the control group, and the favorable prognosis rate in the observation group was significantly higher than that in the control group(P<0.05). Conclusion Early minimally - pinvasive uncture and drainage has significant efficacy, and can effectively improve the neurological function of patients with hypertensive basal ganglia cerebral hemorrhage, reduce complications and improve prognosis.