Objective To compare the clinical efficacy of multi-target lateral puncture combined with intracranial pressure monitoring in treatment of basal ganglia hypertensive cerebral hemorrhage. Methods Sixty-six patients of basal ganglia hypertensive cerebral hemorrhage, with bleeding volume over 40 ml were divided into experimental group (36 cases) and control group (30 cases) by random digits table method. Patients in experimental group underwent multi-target puncture combined with routine intracerebroventricular treatment of intracranial pressure monitoring,and patients in control group underwent frontotemporal craniotomy and small hematoma decompressive craniotomy. The operation time, length of stay, hematoma evacuation rate, catheter drainage time, total amount of mannitol, Glasgow Coma Scale (GCS) scores 3 days after treatment, complication rate and 3-month Glasgow Outcome Scale (GOS) scores were recorded and compared between two groups. Results The operation time, length of stay, hematoma evacuation rate 1 day after treatment, and total amount of mannitol in experimental group were significantly lower than those in control group: (67.5±8.0) min vs. (109.3±9.6) min, (18.6±4.2) min vs. (23.3±5.9) min, (59.7±9.2)% vs. (80.4±11.6)%, (668.6±83.5) g vs. (1 430.4±107.1) g, P<0.01. The hematoma evacuation rate 3 days after treatment, catheter drainage time and GCS scores 3 days after treatment between two groups had no significant differences (P>0.05). The GOS scores in experimental group: 5 points (9 cases), 4 points (10 cases), 3 points (8 cases), 2 points(5 cases), and 1 point(4 cases). The GOS scores in control group: 5 points (4 cases), 4 points (4 cases), 3 points (7 cases), 2 points (9 cases), and 1 point (6 cases). Long curative effect in experimental group was better than that in control group (Z =2.318, P =0.020). The incidence of intracranial air in experimental group was significantly higher than that in control group: 27.8%(10/36) vs. 3.3%(1/30), P<0.05. Other complications had no significant differences between two groups (P>0.05). Conclusions Multi-target lateral puncture combined with intracranial pressure monitoring in treatment of basal ganglia hypertensive cerebral hemorrhage has more advantages, including less trauma, wide surgical indications, short operation time and hospital stay, less postoperative mannitol, and decreased mortality rate. For older, patients with organ dysfunction, and patients who can not tolerate craniotomy, it is an effective treatment, and worthy of promotion.