Objective To prospectively study the minimally invasive hematoma stereotactic aspiration and the recovery of neurological deficits after conservative medical treatment alone, as well as the incidence of post-stroke depression (PSD) in patients with intracerebral hemorrhage, so as to investigate the effect of minimally invasive hernatorna stereotactic aspiration on the recovery of neurological deficits and the incidence of PSD. Methods Fifty-five patients with intracerebral hemorrhage received minimally invasive hematoma stereotactic aspiration (n =25) and conservative medical treatment (n = 30), respectively. The neurological deficits of the patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) at admission, day 14 and 90. The decreased values (all compared to baseline score) of the NIHSS scores were calculated at day 14 and 90, respectively; the modified Rankin Scale (mRS) was used to assess the disabled degree at day 90; the 17-item Hamilton Depression Rating Scale (HAMD) was used to assess the PDS status at day 14 and 90. The correlation between PSD and the degrees of neurological deficit and disability in patients was analyzed. Results The decreased value of the NIHSS score in the stereotactic group at day 14 and 90 was significantly higher than that in the conservative treatment group (all P ＜0. 05), and the value of the mRS score was significantly lover than that in the conservative treatment group at day90 (P＜0. 05). The incidence and the total incidence of PSD in the stereotactic group at day 90 were significantly lover than those in the conservative treatment group (all P ＜0.05). There were significant positive correlation between HAMD and NIHSS scores and HAMD and mRS scores. Conclusions The recovery of neurological deficits was faster after the minimally invasive hematoma stereotactic aspiration. The degree of disability in patients was lower, and the incidence of PSD was also lower than that in the conservative treatment group. PSD was closely correlated with the degrees of neurological deficits and disability.