〔Abstract〕Objective To observe the short-term and long-term effects of minimally invasive hematoma external drainage under intracranial pressure (ICP) monitoring in the treatment of hypertensive intracerebral hemorrhage in the basal ganglia. Methods 308 patients with hypertensive intracerebral hemorrhage in basal ganglia were treated in the Zhoukou Hospital of Traditional Chinese Medicine from June 2015 to June 2020 were selected as the research objects. They were randomly divided into observation group and control group, with 154 cases in each group according to the random table method. The control group underwent large bone flap craniotomy for hematoma removal, and the observation group underwent minimally invasive hematoma drainage under ICP monitoring. The operation related indexes and short-term and long-term effects were compared between the two groups. Results The operation time and hospital stay in the observation group were shorter than those in the control group, and the postoperative rebleeding rate was significantly lower than that in the control group, the differences were statistically significant (P < 0.05); 1 month after operation, the total effective rate in the observation group was significantly higher than that in the control group, the difference was statistically significant (P < 0.05); 6 months after operation, the rate of good prognosis in the observation group was significantly higher than that in the control group, the difference was statistically significant (P < 0.05). Conclusion Minimally invasive hematoma external drainage under ICP monitoring in the treatment of hypertensive intracerebral hemorrhage in basal ganglia can significantly shorten the operation time and hospital stay, reduce the rebleeding rate, and improve the short-term and long-term treatment effect.