Objective To explore the clinical efficacy of robotic⁃assisted stereotaxic aspiration and endos⁃ copy⁃assisted debridement of hypertensive small and medium⁃sized hematomas in the basal ganglia. Methods The clinical data of 118 patients with hypertensive small and medium⁃sized hematoma（25 ~ 55 mL）in the basal ganglia who were admitted to South Taihu Hospital，Huzhou University from April 2019 to November 2021 were retrospectively analyzed. According to the treatment methods，they were divided into surgical robot⁃assisted stereo⁃ taxic puncture and aspiration group（study group）and endoscopic hematoma removal group（control group）. The two groups were compared in terms of the general clinical data on admission，the incidence of complications during hospitalization，the length of hospital stay，and the recovery of lower limb muscle strength on the hemiplegic side at the time of discharge. Results There was no significant difference in the average score and hematoma volume between the two groups（P > 0.05）. There was no significant difference in the incidence of rebleeding，stress ulcer pulmonary infection，intracranial infection and deep vein thrombosis between the two groups during hospitalization （P > 0.05）. The length of hospital stay in the study group was significantly shorter than that in the control group ［（17.32 ± 4.59）d vs.（26.350 ± 4.93）d，P < 0.05）］. After 6⁃month follow⁃up，the proportion of muscle strength of the lower limbs of the hemiplegic side Ⅳ~Ⅴ in the study group was significantly higher than that in the control group（P < 0.05）. Conclusion Surgical robot⁃assisted stereotaxic puncture and aspiration for removing intracerebral hematoma is less traumatic. It can shorten the hospitalization duration，improve the prognosis，and improve the quality of life，thereby worthy of clinical promotion.