Abstract: Objective To compare the clinical efficacy of neuroendoscopic transcortical fenestration of septum pellucidum and conventional ventricular drainage in treatment of intraventricular hemorrhage. Methods Total 112 patients with spontaneous intraventricular hemorrhage in our hospital from Jun.2012 to Jun.2014 were randomly divided into observation group(57 cases) and control group(55 cases).The observation group received neuroendoscopic transcortical fenestration of septum pellucidum,while control group received external ventricle drainage.The time of operation,removal of hematoma,indwelling time,postoperative complications (secondary hemorrhage,intracranial infection,hydrocephalus),disease duration,mortality,Glasgow prognostic score GOS) 3 months later,and other clinical curative effect index were observed.The statistical analysis was carried out by SPSS 13.0 software,The quantitative data was described with mean and standard deviation( s),Student t-test for the quantitative variables and Chi-square test for the categorical variables,and Wilcoxon signed-rank test for rank data were performed.The prognosis of the two groups was compared by statistical analysis. Results 3 days after the operation,CT showed that the hematoma clearance rate was greater than 50% in the 50 cases (87.72%) of the treatment group and 18 cases(32.73%) in the control group .Statistical analysis:Z=6.2002，P＜0.01,there were significant differences.At the same time,the postoperative complications,the time of catheterization,the course of disease,the mortality,and the prognosis of the Glasgow(GOS) 3 month after the operation were better than that in the control group(χ²=4.193，χ²=11.009，χ²=9.843，t=14.096，t=14.629，Z=3.239，P＜0.05).The operation time between the two groups had no statistically significance(P＞0.05). Conclusion The removal of ventricular hemorrhage with neuroendoscopic transcortical fenestration of septum pellucidum has higher hematoma clearance rate,can obviously reduce the morbidity and mortality in patients with spontaneous intraventricular hemorrhage,reduce complications,shorten the course of the disease,and reduce the economic burden of patients.