Abstract： Objective:To explore and analyze the clinical effects of neuroendoscopy and craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods:A total of 108 patients with hypertensive cerebral hemorrhage admitted to the department of Neurosurgery of Linfen People′s Hospital from April 2018 to April 2020 were selected.There were 57 males and 51 females, aged(58.12±4.25)years old, and the age range was 46 to 71 years, According to different surgical methods, they were divided into neuroendoscopy group( n=60)and craniotomy group( n=48). The two groups were compared with perioperative indicators, endothelin, C-reactive protein(CRP), interleukin-6(IL-6), the incidence of postoperative complications before and after treatment, and the prognosis of the 6-month follow-up. Results:The clearance rate of hematoma in the neuroendoscopy group[(89.21±6.15)%]was higher than that of the craniotomy group[(73.53±4.66)%], and the operation time[(2.12±1.08)h]was shorter than that of the craniotomy group[(5.78±1.14)h], intraoperative blood loss[(99.54±30.57)ml]less than craniotomy group[(261.36±12.98)ml], postoperative intensive care unit(ICU)time[(7.24±2.31)d]short In the craniotomy group[(11.35±2.25)d], the Glasgow Coma Index(GCS)score[(12.96±1.52)points]was higher than that in the craniotomy group[(11.30±1.26)points], within 24 hours after operation.The length of hospital stay[(31.50±3.41)d]was shorter than that of the craniotomy group[(39.48±4.25)d]; after treatment, endothelin[(67.96±8.77)ng/L], CRP[(15.11±2.83)mg/L]and IL-6[(23.45±3.62)μg/L]are lower than the craniotomy group[(85.41±10.54)ng/L, (21.58±3.65)mg/L, (42.25±5.11)μg/L], the differences were statistically significant( P<0.05). The incidence of postoperative complications in the neuroendoscopy group[3.3%(2/60)]was lower than that in the craniotomy group[18.8%(9/48)], and the difference was statistically significant( χ2=5.346, P=0.021). The neuroendoscopy group had a good prognosis[65.0%(39/60)]higher than that of the craniotomy group[45.8%(22/48)], and the difference was statistically significant( χ2=4.257, P=0.035). Conclusion:Neuroendoscopic treatment of hypertensive cerebral hemorrhage can obtain better perioperative indicators, lower postoperative complications, and better prognosis during follow-up.