To study the clinical effectiveness of cubic oriented stereotactic tube indwelling in combination with diffusion tensor imaging (DTI) as a minimally invasive surgical treatment for lateral internal capsule hemorrhage. Methods: A total of 90 patients with lateral internal capsule hemorrhage were collected and randomly divided into three groups with 30 patients per group according to treatment received. Group A was treated with standard drug therapy, Group B with minimally invasive surgery of cubic oriented stereotactic tube indwelling and standard drug therapy, and Group C with minimally invasive surgery of cubic oriented stereotactic tube indwelling plus DTI for accurately locating puncture site in addition to standard drug therapy. Hematoma size in all groups was compared 5 days after treatment. DTI was performed before treatment and 5 days after treatment in all groups, and the lateral internal capsule hemorrhage in the pyramidal tract was evaluated by fractional anisotropy (FA). The modified National Institute of Health Stroke Scale (mNIHSS) score of each group before treatment and 5 and 56 days after treatment was compared, and the modified Barthel Index (mBI) of each group 56 days after treatment group was compared. Results: There was no significant difference in the hematoma size, FA of the pyramidal tract, neurological impairments, and self-care ability among the three groups before treatment. After treatment, there was a significant increase in FA, recovery of functional impairment, and self-care ability in group B and group C compared to those in group A, and furthermore, there was a greater increase in group C compared to group B (all P<0.05). Conclusion: Minimally invasive surgery of cubic oriented stereotactic tube indwelling in combination with DTI is an effective method of treating hypertensive intracerebral hemorrhage.