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¹İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, and medical and surgical management have improved the management of ICH. A multidisciplinary approach is recommended, with participation of vascular neurology, vascular neurosurgery, critical care, and rehabilitation medicine as the main players. Young age and hematoma volume are significant predictors for detection of a bleeding source in the event of basal ganglia hemorrhage. To date, craniotomy has been the most commonly used surgical intervention for spontaneous ICH. With advances in technology, minimally invasive surgery, including endoscopic surgery (ES) and minimally invasive puncture and drainage (MIPD), is expected to be one of the most promising surgical procedures for the treatment of spontaneous ICH, particularly deep hematomas. Moreover navigation-guided hematoma puncture aspiration and catheter drainage is simple, effective, and safe as a treatment for hypertensive basal ganglia hemorrhage. However, the usefulness of surgery for most patients with ICH is uncertain. The role of surgical hematoma evacuation for deep or ganglionic hematomas remains controversial. Anahtar Kelimeler : Basal ganglia, Hemorrhage, Endoscopic surgery, Vascular, Minimally invasive surgery