Objective To investigate the clinical efficacy of minimally invasive soft channel surgery in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods Ninety-eight HICH patients, who were diagnosed and treated in the 285th Hospital of PLA in Handan, Hebei Province, China from January 2014 to December 2015, were randomly divided into soft channel group and hard channel group, each with 49 cases. The two groups received the same basic treatment, and were compared in terms of their surgical effect, prognosis, and quality of life (QOL).Results The soft channel group had a significantly longer operation time than the hard channel group (P<0.05). The incidence of subdural hematoma in the soft channel group was significantly lower than that in the hard channel group (2.04% vs 14.29%, P<0.05). At four weeks after surgery, the cure and marked response rate in the soft channel group was significantly higher than that in the hard channel group (73.47% vs 53.06%, P<0.05). The soft channel group also had a slightly higher overall response rate than the hard channel group (97.96% vs 95.92%), but without a significant difference (P>0.05). At 3 and 6 months after surgery, the soft channel group had significantly higher Barthel index and QOL score than the hard channel group (P<0.05).Conclusions Compared with those treated with hard channel surgery, HICH patients treated with minimally invasive soft channel surgery have fewer postoperative complications and better recovery from surgery.