In the past two decades, the development of minimally invasive surgery (MIS) for hematoma clearance has brought new approaches to the treatment of intracerebral hemorrhage. At the same time, the development of minimally invasive puncture and aspiration devices has promoted the development of MIS. This review provides a detailed introduction to the representative puncturing and aspiration instruments for four representative minimally invasive surgical procedures (craniopuncture, stereotactic soft channel puncture and drainage, neuroendoscopic surgery, and small bone window microsurgery). The ultimate goal of hematoma clearance should be achieving minimally invasive, visualizable, intelligent, and individualized treatment. Currently available instruments have met the needs of minimally invasive and visualizable treatment, but in the future, more instrument innovation is needed to achieve intelligent and individualized treatment, so as to ultimately achieve homogenization of minimally invasive hematoma clearance treatment for intracerebral hemorrhage.