Objective:To explore the clinical efficacy of spontaneous intracerebral hemorrhage treated by minimally invasive puncture assisted by image post-processing combined with 3D printing surgical guide plate.Methods:The clinical data of 76 patients with spontaneous intracerebral hemorrhage admitted to Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2022 were retrospectively analyzed. According to different guiding ways at minimally invasive puncture, they were divided into a control group guided by imaging positioning ( n=43) and an observation group guided by image post-processing combined with 3D printing surgical guide plate ( n=33). The differences of postoperative clinical efficacies were compared between the two groups, including one-time puncture success rate, puncture accuracy rate, hematoma clearance rate on 3 rd d of surgery, postoperative complications, and prognoses 3 months after surgery. Results:Patients in the observation group had significantly higher success rate of one-time puncture (100.0% vs. 83.7%), puncture accuracy (90.9% vs. 72.1%), effective hematoma clearance on the 3 rd d of surgery (93.9% vs. 76.7%), good prognosis rate 3 month after surgery (84.8% vs. 62.8%) than those of the control group ( P<0.05). There was no significant difference in postoperative intracranial infection (9.1% vs. 11.6%) or puncture path bleeding rate (6.1% vs. 9.3%) between the two groups ( P>0.05). Conclusion:minimally invasive puncture assisted by image post-processing and 3D printed surgical guide plate can more accurately puncture hematoma in the treatment of spontaneous intracerebral hemorrhage, and its clinical efficacy is more satisfactory than the convention one; moreover, minimally invasive puncture can help to achieve treatment homogenization.