Objective To investigate the curative effects of keyhole microsurgical craniotomy to hypertension cerebral hemorrhage. Methods Treatment and curative effects were retrospectively reviewed in 68 patients of hypertension cerebral hemorrhage from Jan. 2008 to Dec. 2010. Results After treatment with keyhole microsurgical craniotomy, in 68 patients, besides 1 case death, in 3-12 month follow-up, level Ⅰ (complete recovery) 22 occupies 32.3%, level Ⅱ (self care) 20 occupies 29.3%, level Ⅲ (requires assistance) 19 occupies 27.9%, level Ⅳ (confined to the bed but conciousness) 4 occupies 5.9%, level Ⅴ (vegitative survival) 2 occupies 2.9%. Conclusion The curative effect of keyhole microsurgical craniotomy to hypertension cerebral hemorrhage is remarkable.