Objective To investigate the techniques,effectiveness of interhemispheric transcorpus callosal approach with septostomy or frontal transcortical approach for the management of primary hypertensive ventricular hemorrhage.Methods Eighteen patients with primary ventricular hemorrhage or thalamicorcaudate hemorrhage complicated by ventricular hemorrhage received operation for removal of intraventricular blood clots by the interhemispheric,transcorpus callosal approach with septostomy or frontal transcortical approach.All patients received brain CT examination before and after surgery.The clinical outcomes were assessed 3 months after surgery by GOS.Results Good clinical outcomes ( GOS ≥4) were achieved in 50% of patients.The overall mortality rate at 3 months postsurgery was 6%.Conclusions The interhemispheric transcorpus callosal approach with septostomy or frontal transcortical approach is safe and effective for direct removal of intraventricular blood clots for the treatment of supratentorial ventricular hemorrhage with obstructive hydrocephalus. Key words: Intraventricular hemorrhage; Craniotomy; Interhemisphere trancorpus callosal approach; Frontal transcortical approach