Objective To investigate the difference between the outcome of patients with easily dilated hematoma and those without easily dilated hematoma after stereotactic hematoma puncture. Methods 127 patients with hypertensive cerebral hemorrhage who underwent stereotactic hematoma puncture in our department from January 2019 to December 2022 were included. According to the CT signs of the CT scan, the patients were divided into the easily dilated hematoma group and the non-easily dilated hematoma group. The age, gender, smoking and drinking history, GCS score, hematoma volume, hematoma location, operation time, postoperative re-bleeding and mRS score were compared between the two groups. Results There were no significant differences in GCS score, hematoma volume, hematoma location, postoperative re-bleeding and surgical time between the two groups (P>0.05). Compared with patients with easily dilated hematomas, patients with non-easily dilated hematomas have a significantly higher rate of poor prognosis (mRS 3-6 points) (65.9% vs. 39.5%), with a statistically significant difference (P<0.05); Further logistic regression analysis showed that easily dilated hematoma (P<0.05) was an independent risk factor associated with poor prognosis in patients. Conclusions Patients with easily dilated hematomas have a higher risk of poor outcome after stereotactic puncture than those with non-easily dilated hematomas.