Objective To explore the application values of computed tomography (CT)- guided minimally invasive evacuation of hematoma in the treatment of spontaneous intracerebral hemorrhage in basal ganglia. Methods 102 patients with spontaneous intracerebral hemorrhage were divided into the CT group (n=51) and the internal medicine group (n=51) according to the treatment methods. The internal medicine group was given the internal medicine conservative treatment, and the CT group was given the CT-guided minimally invasive evacuation of hematoma on this basis. The clinical efficacy of the two groups was observed. Results The total effective rates of the CT group and the internal medicine group were 88.24% and 72.55% respectively (P<0.05), and the complications rates during hospitalization were 5.88% and 7.84% respectively (P>0.05), and the survival rates during follow-up were 100% and 92.16% (P<0.05). Compared with before treatment, the hematoma volume was decreased gradually at 2w and 4w after treatment (P<0.05), and there were significant differences between-groups and withingroups at different time points after treatment (P<0.05). Compared with before treatment, the NIHSS score at 2w and 4w after treatment was decreased gradually while the Barthel index score was gradually increased (P<0.05), and there were significant differences in the above scores between-groups and within-groups at different time points after treatment (P<0.05). Conclusion CT-guided minimally invasive evacuation of hematoma has the advantages of precise targeting, reducing risk of postoperative complications and death such as nerve injury, and high hematoma clearance rate. It hs significant efficacy in the treatment of patients with spontaneous intracerebral hemorrhage in basal ganglia, and can effectively improve the nerve injury, and it is conducive to the improvement of their daily living activities, and it has high clinical application values.