Objective To investigate the effects of small bone window craniotomy, hematoma evacuation via the pterional-transsylvian approach combined with decompressive craniectomy, and percutaneous drainage on the long-term neurological function and intracranial infection in patients with basal ganglia hemorrhage.Methods A total of 87 patients with basal ganglia hemorrhage were randomly divided into small bone window craniotomy group (group A), percutaneous drainage group (group B), and hematoma evacuation via the pterional-transsylvian approach combined with decompressive craniectomy group (group C) using a random number table. The long-term neurological function and intracranial infection were analyzed and compared between the three groups.Results Group B had a significantly higher Glasgow Outcome Scale score than group A (t=5.14 and 6.33, P<0.05). Group B and group C had a significantly higher hematoma evacuation rate than group A (t=7.90, P<0.05). And they also had significantly higher modified Rankin score and Barthel score than group A (t=2.69, 3.01, 3.47, and 5.52, P<0.05). There was no significant difference in intracranial infection rate between the three groups (P>0.05).Conclusions For the treatment of basal ganglia hemorrhage, percutaneous drainage and hematoma evacuation via the pterional-transsylvian approach combined with decompressive craniectomy can produce a greater improvement in long-term neurological function than small bone window craniotomy. However, there is no significant difference in postoperative intracranial infection rate between them.