Objective To observe the effect of severe hypertensive cerebral hemorrhage with minimally invasive technology. Method Fifty patients of severe hypertensive cerebral hemorrhage treated by minimally invasive puncture combined early systemic rehabilitation (treatment group), and 49 patients with conventional treatment as control group. Results (1)The survival number were 37 cases in treatment group and 28 cases in control group. The survival patients with GCS after 4 weeks in treatment group was significantly higher than that in control group (P < 0.01). (2) FIM score of treatment group and control group on admission [(58±12) scores vs (60±11) scores] and the 14 th day [(64±13) scores vs (62±12) scores] after treatment, there was no significant difference (P > 0.05), but the FIM score of treatment group at the first month [(76±16) scores vs (65±14) scores] and the third month [(90±22) scores vs (69±18) scores] after treatment were significantly superior to eontrol group (P < 0.05). (3) NIHSS score of treatment group and control group on admission were (17.5±3.5) scores and (16.9±3.4) scores (P > 0.05), the NIHSS score of treatment group at the 14th day,the first month and the third month were significantly superior to control group [(14.3±3.3) scores vs (16.2±3.5) scores, (12.1±2.4) scores vs (15.7±3.4) scores, (9.0±3.4) scores vs(12.2±23.6) scores, respectively] (P< 0.05). Conclusion The treatment of severe hypertensive cerebral hemorrhage with minimally invasive percutaneous is safe and effective, the effect is superior to conventional medical treatment.