Abstract: Objective To evaluate the clinical efficacy of 3D printing combined with magnetic resonance diffusion tensor imaging(DTI) and positioning drilling in the treatment of hypertensive intracerebral hemorrhage.Methods A total of 46 patients who suffered from intracerebral hemorrhage and underwent drilling and drainage from January 2017 to January 2022 were selected. The experimental group(n=21) was subjected to 3D printing and DTI, while the control group(n=25) were treated with 3D printing and positioning puncture alone. Both groups were compared for clinical effectiveness.Results There were no significant differences in the length of hospitalization stay, hospitalization expense, drainage effect, common complications and mortality between the two groups(P>0.05). The experimental group showed higher daily living ability than the control group(90.47% vs 72.00%, P<0.05).Conclusions Compared with 3D printing and positioning puncture, the combined use of 3D printing and DTI can effectively improve the prognosis of patients with hypertensive intracerebral hemorrhage.