Abstract: OBJECTIVE To explore the application value of urokinase irrigation in minimally invasive puncture and drainage of intracerebral hemorrhage. METHODS One hundred and six patients with supratentorial spontaneous intracerebral hemorrhage were randomly divided into two groups: the control group(51 cases) and the observation group(55 cases). Both groups were treated with internal medicine and minimally invasive puncture and drainage. The control group was treated with urokinase (2×10⁴‒5×10⁴ U) one time perfusion liquid drainage, the observation group was treated with urokinase(2×10⁴‒5×10⁴ U at a time) dissolved in 30 mL of 0.9% sodium chloride of repeated irrigation. Preoperative, and on the 3rd, 5th and 14th day after operation, the volume of hematoma, volume of perihematomal low-density area, and the National Institutes of Health Stroke Scale(NIHSS) score were compared between the two groups; the time of removing hematoma drainage tube was compared between the two groups; the incidence of rebleeding, intracranial infection, stroke-associated pneumonia(SAP), central hyperthermia, stress related mucosal disease(SRMD) were compared between the two groups. The cumulative mortality, modified Rankin Scale(mRS) score, Barthel index score of the two groups at 3 months after operation was compared. RESULTS Compared with the control group, the volume of hematoma in the observation group decreased significantly on the 3rd, 5th and 14th day after operation(P<0.05 or P<0.01). Compared with the control group, the volume of the low density area around the hematoma and the NIHSS score of the observation group was decreased on the 5th and 14th day after operation(P<0.05 or P<0.01). The time of removal of hematoma drainage tube in the observation group was lower than that in the control group(P<0.01). There was no significant difference in the incidence of rebleeding, intracranial infection, SAP, central hyperthermia, SRMD between the two groups. At 3 months after operation, there was no significant difference in the cumulative fatality rate between the two groups, compared with the control group, the mRS score in the observation group were lower, and the Barthel index score in the observation group were higher(P<0.05). CONCLUSION The application of urokinase irrigation for hematoma in minimally invasive puncture and drainage of intracerebral hemorrhage can shorten the clearance time of hematoma, reduce brain edema, improve the prognosis, and do not increase the incidence of rebleeding and intracranial infection.