Objective To investigate the clinical effect of minimally invasive surgery and optimal time for surgery in the treatment of basal ganglia hemorrhage.Methods Patients with basal ganglia hemorrhage (>30 ml) from 2005 to 2012 were selected in the study. These patients were divided into control group (n=86) who received conservative treatment, observation group 1 (n=89) who received small bone window craniotomy, and observation group 2 (n=93) who received CT-guided minimally invasive hematoma drainage. The treatment outcome of each group and the optimal time for surgery were analyzed.Results Observation group 2 had a significantly shorter duration of surgery and significantly less hemorrhage during surgery than observation group 1. Compared with the control group and observation group 1, observation group 2 had a shorter mean length of hospital stay, a lower fatality rate, a lower NIHSS score within 2 weeks, and a better recovery of neurological function (P<0.05), and observation group 1 showed improvements in the above indices compared with the control group. The patients who underwent minimally invasive surgery within 6 hours after cerebral hemorrhage had a higher rehemorrhage rate after operation, a shorter mean length of hospital stay, improved neurological function, and a lower overall fatality rate, as compared with those who underwent surgery at 6-48 hours and later than 48 hours after cerebral hemorrhage. The patients who underwent minimally invasive surgery at 6-48 hours after cerebral hemorrhage had a relatively low rehemorrhage rate;the patients who underwent minimally invasive surgery later than 48 hours after cerebral hemorrhage showed no significant improvement in neurological function.Conclusions For basal ganglia hemorrhage (>30 ml), minimally invasive hematoma drainage, which has a short duration of surgery and causes little hemorrhage, has a significantly improved clinical effect, and it can significantly reduce the fatality and promote the recovery of neurological function. The minimally invasive surgery performed within 6 hours after cerebral hemorrhage is of great significance for shortening hospital stay and restoring neurological function.