Objective To analyze the advantages of rapid pore cranial drilling and drainage treatment on hypertensive basal ganglia hemorrhage(HBGH), comparing with conventional open craniotomy(COC). Methods We retrospectively studied the clinical dates of 589 HBGH patients, in which 430 cases were treated using rapid pore cranial drilling and drainage method (puncture group) and 159 cases with conventional open craniotomy (control group). Results In puncture group,good outcome was accomplished (ADL Ⅰ Ⅱ Ⅲ) in 306 patients (88.4%), poor outcome (ADL Ⅳ Ⅴ) in 40 patients (11.6%), and 84 patients died.(19.5%). In control group, the outcome was good (ADL Ⅰ Ⅱ Ⅲ)in 50 cases (49.0%), poor (ADL Ⅳ Ⅴ) in 52 cases (51.0%), and 57 cases died. (34.0%). There was distinctly statistical significance in clinical outcome between the two groups (P<0.05). The mortality and good outcome of minimal invasive group significantly better than that of COC groups. Conclusions For its safe, effective, simple, economic, minimally invasive feasible,the rapid pore cranial drilling and drainage is a valuable method in treatment of hypertensive basal ganglia hemorrhage.