To compare the clinical curative effect of stereotactic evacuation of hematoma and neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods: A total of 70 patients with HICH were retrospectively enrolled in the study. Among them, 35 patients treated by neuroendoscopy were included in the neuroendoscopy group and 35 patients treated by stereotactic evacuation of hematoma were included in the stereotactic group. The relevant surgical indexes, postoperative complications, mortality rate within 1 month of surgery, and Glasgow Outcome Scale (GOS) score at 6 months after surgery were compared between the two groups. Results: Compared to that of the neuroendoscopy group, the surgical time of the stereotactic group was significantly shorter (t=－9.483, P=0.000) and the hematoma clearance rate was significantly lower (t=－ 11.105, P=0.000). There was no incidence of rebleeding in the neuroendoscopy group after surgery, and the rebleeding rate of the stereotactic group was significantly higher than that of the neuroendoscopy group (χ2=9.032, P=0.003). There was no significant difference in the incidence of complications or mortality rate between the two groups (P>0.05). The long-term GOS score of the neuroendoscopy group at 6 months after surgery was significantly better than that of the stereotactic group (P<0.05). Conclusion: Neuroendoscopic surgery is more effective than stereotactic evacuation of hematoma in the treatment of HICH.