Abstract: Objective To investigate the clinical effect of microsurgery for hypertensive basal ganglia cerebral hemorrhage and provide theoretical basis for clinical application. Methods Total 62 patients with hypertensive basal ganglia cerebral hemorrhage who underwent surgery at the First People's Hospital of Chuzhou from November 2016 to September 2019 were selected as research subjects. They were simply and randomly divided into observation group and control group, and 32 cases in the observation group were treated with microscope, 30 patients in the control group were treated with traditional craniotomy. χ² test and t test were used to compare the general clinical data of two groups, t test was used to compare the operation time and intraoperative blood loss of the two groups, and χ² test was used to compare common complications (rebleeding, pulmonary infection, cerebral infarction, stress ulcers, and epilepsy) during postoperative hospitalization, and the Glasgow outcome scale (GOS) at 3 months after surgery in the two groups. Results The operation time in the observation group was (171.18±38.65) minutes, which was shorter than that in the control group[(183.67±33.50) minutes], the difference was not statistically significant (P=0.181). The intraoperative blood loss in the observation group was (164.06±36.71) mL, which was less than that in the control group[(178.67±38.48) mL], the difference was not statistically significant (P=0.131). The incidence of common complications during the postoperative hospital stay in the observation group was 40.63%, which was significantly less than 70.00% in the control group, the difference was statistically significant (P=0.020). The good prognosis of GOS classification in the observation group was 65.63% at 3 months after operation, which was significantly higher than that in the control group (40.00%), the difference was statistically significant (P=0.043). Conclusion Compared with traditional surgery, microsurgery for hypertensive basal ganglia cerebral hemorrhage has the characteristics of low complication rate and better recent prognosis, which is worthy of clinical application.