BackgroundWe aimed to investigate the clinical effectiveness of integrating 3D-printing technology with neuroendoscopy for treating hypertensive intracerebral hemorrhage (HICH). MethodsBetween November 2020 and November 2023, a total of 105 HICH cases were selected and categorized into the conventional surgery group and the neuroendoscopic surgery. General data, Glasgow Coma Scale (GCS), National institutes of health neurological impairment score (NIHSS), preoperative hematoma volume, intracerebral parenchymal and intraventricular hematoma (IVH) clearance rates, Modified Graeb Scale (mGS), postoperative rebleeding rate, intracranial infection, and Modified Rankin Scale (mRS) were collected to assess the therapeutic effectiveness. ResultsThere were no significant statistical differences in gender, age, preoperative GCS scores, NIHSS or hematoma volume between the neuroendoscopic surgery and conventional surgery group. The postoperative results indicated that the clearance rate of intracerebral parenchymal and IVH in neuroendoscopic surgery group was notably higher than the conventional surgery group. The neuroendoscopic surgery group achieved superior outcomes in terms of bone flap area, operation time, extubation time, and average hospital stay compared to the conventional surgery group (P < 0.05). Following a 3-month follow-up, there was no significant difference in the mRS and NIHSS between the two groups. However, when the patients with IVH (mGS≥10) indicated better postoperative outcomes in the neuroendoscopic surgery group (P < 0.05). ConclusionThe integration of neuroendoscopic minimally invasive surgery with 3D-printing technology for treating HICH demonstrated high efficacy for removing intracerebral and IVH. This approach incurred less trauma compared to traditional craniectomy surgery, affording shortened surgical and hospitalization durations. Consequently, it appears to be a highly efficacious method for treating HICH, particularly in cases involving IVH.