〔Abstract〕 Objective To explore the efficacy and safety of minimally invasive surgery for spontaneous intracerebral hemorrhage. Methods A total of 68 patients with spontaneous intracerebral hemorrhage admitted to Zhongshan Dongfeng People's Hospital from February 2017 to February 2020 were selected. The patients were divided into control group (conventional treatment) and observation group (minimally invasive surgery) with 34 cases in each group. Results The duration of operation, length of hospital stay, first exhaust time and time to get out of bed in observation group were shorter than those in control group, and the amount of intraoperative blood loss in the observation group was less than that in control group, with statistical significance (P < 0.05). The total effective rate of the observation group was 94.1 %, higher than 73.5 % of the control group, the difference was statistically significant (P < 0.05). After treatment, the scores of national institutes of health stroke scale (NIHSS) and activities of daily living (ADL) in the two groups decreased to varying degrees, and the differences were statistically significant (P < 0.05). After treatment, NIHSS score of observation group was lower than that of the control group, ADL score was higher than that of the control group, the differences were statistically significant (P < 0.05). Conclusion Minimally invasive surgical treatment in patients with spontaneous intracerebral hemorrhage can improve surgical clinical indicators, reduce NIHSS score, improve ADL score, and improve the treatment efficiency and quality of life of patients.