Abstract: Objective:To explore the indications and effects of large bone flap craniotomy and small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage.Methods:One hundred and sixty-eight patients with hypertensive cerebral hemorrhage were treated with large bone flap craniotomy and small bone window craniotomy.The patients were divided into two groups according to the Glascow Coma Scale and amount of bleeding.The curative effects between two groups were compared.Results:The time of operation and hospitalization and Glascow Outcome Scale score in patients treated with the small bone flap craniotomy were significantly shorter and higher than those in patients treated with large bone flap craniotomy, respectively(P<0.01).The difference of rebleeding rate between two groups was not statistically significant(P>0.05).The large bone flap craniotomy combined with decompressive craniectomy for treating the patients with haemorrhage amount more than 50 ml could significantly reduce the mortality rate(P<0.05).Conclusions:Different bone flap craniotomy in treating hypertensive cerebral hemorrhage has different advantages and disadvantages.Selecting suitable operation according to the amount of bleeding and GCS score can improve the success rate of treatment and quality of life.