AIM: The aim of the retrospective study was to compare the clinical efficacy of the traditional way of aspiration and the modified way of aspiration. MATERIAL and METHODS: Clinical data of total 159 patients with spontaneous intracerebral hemorrhage treated by traditional (group A, n=66) or modified (group B, n=93) way of aspiration (both combined with thrombolysis) were retrospectively analyzed. Reduction of clot volume in the first operation, rate of mortality and re-bleeding, complications, and long-term clinical outcomes of the two groups were compared. RESULTS: Twenty-five out of 159 patients (15.7%) died during in-hospital stay. The mortality and post-operation re-bleeding rate in group B (10.8% and 1.1%) were significantly lower than that in group A (22.7% and 9.1%), (P<0.05). The BI scores of patients in group B (79.5 +/- 23.2) were significantly higher than that in group A (69.2 +/- 23.9), (P<0.05). CONCLUSION: Our data suggested that modifying details of aspiration operation may contribute to the improved prognosis of ICH patients.