Objective To evaluate the efficacy of neuronaviagation-assisted neuroendoscopy via the keyhole with disposable transparent sheaths in the treatment of hypertensive cerebral hemorrhage.Methods The clinical data of 54 patients with hypertensive cerebral hemorrhage who underwent neuronavigation-assisted neuroendoscopy via keyhole with disposable transparent sheaths were reviewed.Results In the 54 patients, the length of scalp incision was 3-4 cm, and the keyhole diameter was 2-2.5 cm; the mean operation time was 70 min (45-110 min), and the mean hematoma clearance rate was 95%. The Glasgow Outcome Score at 6 months after surgery indicated 10 cases of good recovery, 15 cases of mild disability, 27 cases of severe disability, 0 case of vegetative state, and 2 cases of death.Conclusions Neuronavigation-assisted neuroendoscopy via the temporal keyhole using disposable transparent sheaths is a minimally invasive, precise, time-saving, and effective treatment for hypertensive cerebral hemorrhage with good prognosis. Its simple and direct approach makes the technique suitable for wide clinical application.