Objective To examine the effects of different minimally invasive drilling and drainage positions on hematoma clearance, quality of life, and the risk of complications in patients with hypertensive intracerebral hemorrhage in the basal ganglia.Methods One hundred and eight cases of hypertensive intracerebral hemorrhage in the basal ganglia treated in our hospital from 2013 to 2016 were retrospectively analyzed. The 108 cases were divided according to the treatment method into frontal group (n=48) and temporal group (n=60). All patients underwent routine blood pressure monitoring and coagulation tests, as well as CT examination of the brain, prior to surgery. Residual hematoma volume, hematoma clearance time, consciousness recovery time, postoperative rebleeding, incidence of complications, and the ability of daily living (ADL) score at 2 months after operation were compared between the two groups.Results Postoperative (3 d) residual hematoma volume and hematoma clearance time were significantly different between the frontal group (23.2±4.8 ml and 12.2±1.5 d, respectively) and the temporal group (26.7±5.8 ml and 13.8±1.8 d, respectively) (P<0.05). There were no significant differences in the 7-d postoperative residual hematoma volume, consciousness recovery time, postoperative rebleeding, and the length of hospital stay between the frontal and temporal groups (P>0.05). In addition, no significant difference was observed in the incidence of complications (10.4% vs 11.7%) and ADL score (55.1±17.3 vs 53.4±11.9) between the frontal and temporal groups, respectively (P>0.05).Conclusions Different minimally invasive drilling and drainage positions have an effect on early hematoma removal in patients with hypertensive intracerebral hemorrhage in the basal ganglia, where puncture direction parallel to the long axis of the basal ganglia hematoma resulted in better hematoma clearance in the frontal group. However, this positional difference is not associated with the incidence of complications and the quality of life in the patients.