Objective To study the effect of craniocerebral drilling and drainage in the treatment of severe craniocerebral injury complicated with hypertensive intracerebral hemorrhage and its effect on neurological function. Methods 200 cases of patients with severe craniocerebral injury complicated with hypertensive intracerebral hemorrhage who were treated in our hospital from January 2015 to December 2016 were enrolled in this study. According to the different surgical methods, 90 patients were divided into control group and 110 patients in the study group. The patients in the control group were treated with craniotomy and craniotomy. The patients in the study group were treated with craniotomy and drainage. The patients were followed up for 1-3 months. The operative time, postoperative hospital stay, postoperative rebleeding rate and neurological function before and after operation were compared between the two groups. Results The operative time and postoperative hospital stay were lower in the study group than those in the control group. The rate of rebleeding was lower in the study group than in the control group, but there was no significant difference. The neurological function NIHSS score of the two groups was lower than that of the control group at 1 month after operation, and the difference was statistically significant. The total effective rate of the study group was 91.8% (101/110) higher than that of the control group (77.8%, 70/90), the difference was statistically significant. Conclusion Brain drilling and drainage surgery for severe craniocerebral injury complicated by hypertensive intracerebral hemorrhage significantly, short operation time, can effectively reduce the body damage, improve the patient’s neurological function, promote patient rehabilitation.