Abstract: Objective: To explore the clinical effects of straight incision small bone flap craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods: Forty-four patients with hypertensive cerebral hemorrhage were treated with straight incision small bone flap craniotomy to evacuated the hematoma.The therapeutic effects were evaluated.Results: The hematoma disappearance in 36 cases,a small amount of residual hematoma in 5 cases,half residual hematoma in 2 cases and over half residual hematoma in 1 case were found by brain CT scan within 12 to 48 h after operation.Two cases were operated again because of rebleeding,3 cases gave up treatment and discharged,and 1 case died from pulmonary infection.All patients were followed up for 6 to 12 months,grade Ⅰ in 16 cases,grade Ⅱ in 11 cases,grade Ⅲ in 9 cases and grade Ⅳ in 4 cases were found according the score of activity of daily life.Conclusions: Straight incision small bone flap craniotomy for treating hypertensive cerebral hemorrhage is little trauma,quite hemostasis,less secondary brain impair and good daily capacity recovery,the clinical effect is reliable.