Abstract: Objective To explore the effect of neuroendoscopic-assisted intraventricular hematoma drainage in the treatment of thalamic hemorrhage breaking into ventricles. Methods A total of 70 patients with thalamic hemorrhage breaking into ventricles were randomly divided into observation group and control group according to random number table method. The observation group(n=35)was treated by neuroendoscopic-assisted intraventricular hematoma drainage, while the control group(n=35)was treated with external ventricular drainage for hematoma removal. The hematoma removal rate, operation condition, catheterization time, incidence of complications and prognosis were observed. Results The clearance of hematoma in the observation group was significantly better, the operation time was significantly longer, and placement time of drainage tube was significantly shorter, and incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05). After 3 months of follow-up, the excellent rate of prognosis in the observation group was significantly higher than that in the control group(P<0.05). Conclusion Neuroendoscopy-assisted intraventricular hematoma drainage has higher clearance of hematoma, less complication and sequelae, and better treatment efficacy in the treatment of thalamic hemorrhage breaking into ventricles compared with conventional external ventricular drainage.