Abstract: Objective To analyze the application and value of bedside craniocerebral color Doppler ultrasonography in patients with hypertensive intracerebral hemorrhage after decompressive craniectomy. Methods A retrospective analysis of 32 cases from January 2017 to December 2018 in Bozhou People's Hospital of Anhui Province underwent decompressive bone flap decompression and routinely performed real-time monitoring of vital signs, bedside craniocerebral ultrasonography and regular skull CT review Patients with hypertensive cerebral hemorrhage were the experimental group. A total of 32 patients with hypertensive cerebral hemorrhage who had not undergone craniocerebral ultrasonography after decompressive decompression of the bone flap were selected as the control group, and the reoperation, recovery and prognosis of the two groups were compared. Results Patients with intracranial pressure> 20 mm Hg(1 mm Hg=0.133 kPa) in the experimental group after surgery had decreased end-diastolic flow velocity and increased pulsatility index, which was significantly different from those with normal intracranial pressure(all P<0.05). In the experimental group, 9 cases of intracranial lesions were found by bedside cranial color Doppler ultrasound. CT results were used as the gold standard. The coincidence rate of postoperative complications was 81.82%. In the experimental group, 6 patients underwent reoperation, and the intracranial hematoma volume and the lateral ventricle width on the ipsilateral side of the hematoma were highly consistent with CT examination(t=0.155, 0.147, P= 0.880, 0.886). Compared with the control group, the second operation time in the experimental group was faster, the GCS score increased at 1 week postoperatively, the discharge mRs score decreased, and the incidence of cerebral hernia was lower at 90 days after surgery(all P<0.05). Conclusion The use of bedside craniocerebral ultrasound after decompression of hypertensive intracerebral hemorrhage and decompression of bone flaps can monitor the postoperative condition of the patient in time and guide the second operation.