Objective To investigate the positional relationship of cerebral vasculature with path of puncture and drainage in Burr hole removal of intracranial hematoma after cerebral hemorrhage. Methods A total of 60 patients with cerebral hemorrhage undergoing stereotactic puncture and drainage of intracranial hematoma in our department from April 2012 to March 2014 were enrolled in this study. After adequate drainage of the hematoma (more than 90% of hematoma evacuation), cerebral CT angiography (CTA) was carried out before the removal of drainage tube to investigate the positional relationship between cerebral vasculature and the drainage path. Results CTA results indicated that the puncture needle and its path were safe to the surrounding cerebral arteries, the needle tip was positioned accurately, and no obvious damages were seen during the tube dwelling and drainage. All patients had adequate drainage of the hematoma and good recovery after surgery, with a rate of favorable prognosis of 61.67%. Conclusion In Burr hole evacuation with stiff drainage tube of intracranial hematoma, the puncture needle is safe to cerebral vasculature, and its drainage path is safe and reliable.