Abstract: Objective To compare the effectiveness of hematoma clearance via lateral fissure approach and temporal minimally invasive drilling drainage in the treatment of moderate cerebral hemorrhage in the hypertensive basal ganglia. Methods A total of 182 patients with moderate intracerebral hemorrhage in the hypertensive basal ganglia who were admitted into Department of Neurosurgery, the Affiliated Hospital of Xuzhou Medical University from October 2017 to October 2020 were enrolled, including 87 cases in a hematoma clearance via lateral fissure approach group, and 95 cases in a minimally invasive drilling drainage group. Both groups were compared for general information and observation indexes before statistical analysis. Results There were no significant differences in sex, age, hematoma volume, ventricular rupture, midline displacement, postoperative GCS score, postoperative pulmonary infection and intracranial infection between the two groups (P>0.05). Compared with the minimally invasive drilling drainage group, the hematoma clearance via lateral fissure approach group showed an increased postoperative re-bleeding rate as well as an increased hematoma clearance rate and increased GCS scores 7 days after surgery (P<0.05). However, there was no significant difference in GOS score 6 months after operation (P＞0.05). Conclusions Both hematoma clearance via lateral fissure approach and minimally invasive drilling drainage are effectively in the treatment of moderate cerebral hemorrhage in the hypertensive basal ganglia, with little difference in long-term prognosis. Hematoma clearance via lateral fissure approach can remove intracranial hematoma more quickly, where hemostasis can be completely stopped.