Abstract： Objective： To observe the clinical effect of modified Tongfu Zhuyu tang combined with minimally invasive surgery of critical hypertensive intracerebral hemorrhage(HICH) due to severe hypertension. Methods：A total of 42 cases of severe critical HICH patients were selected and divided into the control group and the observation group according to their hospitalizing time，with 20 and 22 cases in each group respectively. The control group was treated with minimally invasive surgery of intracranial hematoma，and the observation group was additionally treated with modified Tongfu Zhuyu tang based on the treatment of the control group. The degree of neurological impairment before and after treatment as well as clinical effects and incidence of complications were compared between the two groups. Results： The total effective rate was 90.91% in the observation group， higher than that of 60.00% in the control group(P＜0.05). After treatment， scores of neurological impairment in the two groups were decreased when compared with those before treatment(P＜0.05)，and the score in the observation group was lower than that in the control group(P＜0.05). The incidence of nausea， dizziness and rebleeding in the observation group was lower than that in the control group(P＜0.05). Conclusion：Modified Tongfu Zhuyu tang combined with minimally invasive surgery of intracranial hematoma for critical HICH can improve the clinical effect and neurological function，and reduce the incidence of postoperative complications.