Objective <p>This study aimed to evaluate the clinical efficacy and safety of minimally invasive hematoma evacuation for the treatment of traumatic intracranial hematoma (TIH).</p> Methods <p>Ninety patients diagnosed with traumatic intracerebral hematoma at Shengli Oilfield Central Hospital from August 2019 to September 2023 were selected as the study subjects. The patients were divided into the craniotomy group (C group, <i>n</i> = 45) and the minimally invasive hematoma evacuation group (MIHE group, <i>n</i> = 45). Patients in group MIHE were treated with minimally invasive hematoma evacuation according to the amount and location of the TIH. The patients’ baseline characteristics, the good prognosis rate, the neurological function index, the hospitalization cost and the incidence rate of complications were compared between the two groups. The status of the patients after surgical treatment was determined according to the Glasgow Outcome Scale.</p> Results <p>The good prognosis rate in the MIHE group (39, 86.67%) was significantly higher than that in the C group (31, 68.89%) (<i>p</i> &lt; 0.05). National Institute of Health stroke scale (NIHSS) scores were significantly lower in the MIHE group than in the C group (<i>p</i> &lt; 0.05). The hospitalization cost and hospitalization time in the MIHE group were significantly lower than those in the C group (<i>p</i> &lt; 0.05). The total incidence rate of complications in the MIHE group (20, 44.44%) was significantly lower than that in the C group (11, 24.44%) (<i>p</i> &lt; 0.05).</p> Conclusion <p>For some patients, minimally invasive hematoma evacuation is a more effective treatment strategy than craniotomy for patients with TIH. It has the advantages of less surgical trauma, complete clearance of hematoma and fewer postoperative complications, which is conducive to the recovery of neurological function and postoperative rehabilitation.</p>