Objective To investigate the effect of small bone window craniotomy assisted with neuroendoscopic evacuation of intracranial hematoma on postoperative neurological function of hypertensive basal ganglia intracerebral hemorrhage. Methods A total of 90 patients with hypertensive basal ganglia hemorrhage admitted from March 2022 to March 2025 were selected. The patients were divided into an observation group and a control group （45 cases each） based on treatment measures. The control group received small bone window craniotomy for intracranial hematoma evacuation, while the observation group underwent small bone window craniotomy with endoscopic-assisted intracranial hematoma evacuation. The quality of life [Short-form 36 health survey （SF-36） score], Fugl-Meyer Assessment, and National Institute of Health Stroke Scale （NIHSS） scores were compared between the two groups. Additionally, the risk of rebleeding and the incidence of surgical complications were compared between the two groups. Results The NIHSS score of the observation group was lower than that of the control group, and the Fugl Meyer score was higher （P<0.05）; the SF-36 bodily pain, general health, vitality, and social functioning scores of the observation group were higher than those of the control group （P<0.05）. The incidence rates of postoperative rebleeding were not different between the two groups （P>0.05）, but the overall incidence rates of complications were lower in the observation group than in the control group（P<0.05）. Conclusion Small bone window craniotomy assisted with neuroendoscopic evacuation of intracranial hematoma has a positive impact on neurological function after surgery for hypertensive basal ganglia intracerebral hemorrhage.