Objective To analyze and compare the short-term effect of neuroendoscopic surgery and craniotomy in the treatment of hypertensive cerebral hemorrhage. Methods From April 2019 to January 2020， 40 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery of Daxing District People's Hospital of Beijing were retrospectively enrolled. All patients were confirmed as supratentorial hematoma by CT. According to different surgical methods， 40 patients were divided into neuroendoscopic group （16 cases） and craniotomy group（ 24 cases）. The effects of the two treatment methods were evaluate by comparing the baseline data of the two groups of patients［ gender， age， hematoma volume， bleeding site， preoperative Glasgow Coma Scale（ GCS） score， time from onset to surgical treatment， etc.］， surgery-related indicators （operating time， intraoperative blood loss， Hematoma clearance rate， postoperative complications） and the ability of daily living score（ Barthel index） before treatment and at discharge. Results Among the 40 patients， 32 were hematomas in the basal ganglia， 4 were subcortical hematomas， and 4 were thalamic hemorrhages. There was no significant difference in gender， bleeding site， age， hematoma volume， preoperative GCS score，and time from onset to treatment between the two groups（ all P＞0.05）. The operation time in neuroendoscopy group was significantly less than that in craniotomy group［ 2（1，3） h vs 3（3，4） h；Z=76.5，P ＜ 0.01］. The intraoperative blood loss in neuroendoscopy group was significantly less than that in craniotomy group［ 100.00 （62.5，137.5） ml vs 500（300，600） ml；Z=33.0，P＜ 0.01］， and the differences were statistically significant. The hematoma clearance rate in neuroendoscopy group was significantly higher than that in craniotomy group［ 83.84 （75.54， 88.89）% vs 58.91（ 15.27，84.23）%；Z=21.0，P=0.02］. The difference of Barthel index score between preoperative and discharge in neuroendoscopy group was significantly higher than that in craniotomy group ［35.0（30.0，35.0） vs 25.0（20.0，30.0）；Z=23.0，P=0.03］. The GCS score at discharge in neuroendoscopy group was significantly higher than that in craniotomy group［ 15.0（7.0，15.0） vs 8.5（5.0，12.0）；Z=42.0，P=0.02］， with statistical significance. The incidence of postoperative pneumonia in craniotomy group was significantly higher than that in neuroendoscopy group（ 9/24 vs 1/16，χ2=5.00，P=0.03）. Conclusions Neuroendoscopic hematoma removal is better than craniotomy hematoma removal in improving the short-term prognosis of patients， and it can be tried for surgical treatment of patients with hypertensive cerebral hemorrhage.