Abstract: Objective：To assess the safety and efficacy of retractorless surgery in spontaneous intracerebral hemorrhage. Methods：Fitysix cases of spontaneous intracerebral hemorrhage treated by retractorless surgery and 59 cases treated by retractor surgery from January 2013 to December 2015 were included. Brain retraction injury rate, hematoma removal rate, rebleeding rate, operation time, 90day modified Rankin score and mortality rate were observed in the two groups. Results：All operations in the retractorless group were successfully completed without the retractor. There was no significant difference in hematoma removal rate, rebleeding rate, operation time and mortality between the two groups. The brain retraction injury rate in the retractorless group was significantly lower than that in the retractor group (P<0.01). 90day modified Rankin score in the retractorless group was significantly better than that in the retractor group. Conclusions：Retractorless surgery can not only reduce the brain retraction injury, but also improve the prognosis of patients with spontaneous intracerebral hemorrhage in the operation of spontaneous intracerebral hemorrhage.