Abstract: Objective: To explore the curative effects of ultra-early extended craniotomy on hypertensive cerebral hemorrhage.Methods: Thirty-eight patients with hypertensive cerebral hemorrhage combined with cerebral hernia were performed hematoma evacuation and decompression through extended craniotomy within 6 hours injury the attack.Patients combined with intraventricular hemorrhage were treated by cerebral ventricle drainage as well as tracheotomy and mechanical ventilator when necessary.Nutritional support was applied to prevent infection and complications;the inner environment was detected;head CT was routinely reviewed after the operation.Results: Hematomas were basically evacuated and 13 patients died after the operation.Conclusions: Ultra-early decompression by extended craniotomy can reduce the mortality in patients with hypertensive cerebral hemorrhage combined with cerebral hernia.