Spontaneous intracerebral hemorrhage (ICH), a devastating neurological emergency, is characterized by a high mortality and mobility due to cerebrovascular rupture and hematoma formation. Here we describe a 52-year-old woman with a 34 ml left external capsule hemorrhage who developed unconsciousness and right hemiplegia. Minimally invasive puncture was subsequently performed followed by thrombolysis therapy for hematoma evacuation. At day 4 after symptom onset, surgery for hematoma evacuation was performed. Specifically, CT imaging was utilized to establish a trajectory for the YL-1 type puncture needle. Once access was established, the hematoma was evacuated through thrombolysis and drainage. After the clot was evacuated, the patient achieved a favorable outcome. The successful outcome achieved in this specific case, suggests that minimally invasive puncture and thrombolysis after intracerebral hemorrhage may be a promising treatment option for hematoma evacuation. (c) 2021 International Hemorrhagic Stroke Association. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).