Objective To evaluate the efficacy of minimally invasive catheter drainage surgery in the treatment of hypertensive intracerebral hemorrhage (HICH). Methods A retrospective analysis was made of 102 HICH patients treated in the Neurosurgery Department of Xi′an Northern Hospital from Feb. 2016 to Aug. 2017, of whom 34 (study group) underwent minimally invasive catheter drainage and 68 (control group) underwent microsurgical removal. The two groups were compared in the operation time, intraoperative bleeding volume, hematoma clearance rate, preoperative and postoperative neuron-specific enolase (NSE) and soluble protein 100-β (S-100β) levels, and activity of daily living (ADL) at 3 months after operation. SPSS statistics 19.0 was used for data analysis, and Studet′s t test or Chi-square test was used to compare between groups. Results Compared with the control group, the study group had shorter operation time [(2.31±0.83) vs (4.02±1.20)h], lower intraoperative bleeding volume[(43.29±9.17) vs (82.28±12.20)ml], and significantly higher clearance rate of hematoma [(88.39±9.12)% vs (79.54±10.21)%] (P<0.001). There was no significant difference in NSE [(23.05±2.78) vs (22.95±3.12)ng/L] and S-100β protein [(1.95±0.21) vs (1.88±0.26)ng/L], and incidence of complications [14.65%(6/34) vs 17.65%(12/68)] (P>0.05) between the two groups. The recovery rate of was 90.91%(30/33) in the study group against 72.73%(48/66) in the control group (P＝0.037). Conclusion Minimally invasive catheter drainage surgery is effective for HICH and is worth popularizing for its minimal invasiveness, speed and less bleeding.