Objective To analyze the clinical effect of mild hypothermia combined with minimally invasive evacuation of intracranial hematoma in the treatment of severe hypertensive intracerebral hemorrhage.Methods: 50 patients with severe hypertensive intracerebral hemorrhage admitted in our hospital from May 2021 to May 2022 were selected and divided into the study group and the control group in order by drawing lots, with 25 patients in each group.The study group was treated with mild hypothermia combined with minimally invasive removal of intracranial hematoma, while the control group was treated with minimally invasive removal of intracranial hematoma.The clinical efficacy, complications, prognosis related scores and serum test indexes of the two groups were compared.Results: The simple intelligence score of the study group was significantly higher than that of the control group, and the NIHSS score was significantly lower than that of the control group (P<0.05); Homocysteine and endothelin in the study group were significantly lower than those in the control group (P; The incidence of complications in the study group was 12%, which was significantly lower than that in the control group (32%, P<0.05); The total effective rate of the study group was 92%, which was significantly higher than that of the control group (68%, P<0.05).Conclusion: Mild hypothermia combined with minimally invasive removal of intracranial hematoma can improve clinical efficacy and reduce nerve damage in patients with severe hypertensive intracerebral hemorrhage.