Objective To explore clinical effects of micro-nurosurgical treatment with small craniotomy lateral fissure approach to treat moderate or severe intraceral hemorrhage from putamen.Methods All of 51 patients with moderate or severe intracerebral hemorrhage were subjected to surgical treatment.Scalp incision was approximate the projection of lateral fissure on head,the diameter of the window of bone was about 3cm.The lateral fissure was opened by anatomizing sylvian cistern.After incising the cortex of insular,hemotoma was removed.Results 11 cases were dead,the mortality was 21 57%.The ADL was accepted as a standard means of describing outcome in these patients .2 cases,were subjected to Grade Ⅰ,6 cases for GradeⅡ,15 cases for GradeⅢ,8 cases for Grade Ⅳ,2 cases for Grade Ⅴ.Conclusions There is no significant difference of outcome between small craniotomy and craniotomy.(Lateral fissure approach) Transsylvian route is very directly for deep hemotomas,and brain injury caused by approach also is very light.